Musculoskeletal adverse reactions after immunotherapy for cancer: A case series

Creţu,Ioana; Bojincă,Mihai; Milicescu,Mihaela; Cursaru,Adrian; Șerban,Bogdan; Crețu,Bogdan; Iordache,Sergiu; Pop,Corina Silvia; Cîrstoiu,Cătălin; Ionescu,Ruxandra

doi:10.3892/etm.2021.10459

September-2021 Volume 22 Issue 3

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September-2021 Volume 22 Issue 3

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Case Report Open Access

Musculoskeletal adverse reactions after immunotherapy for cancer: A case series

Authors:
- Ioana Creţu
- Mihai Bojincă
- Mihaela Milicescu
- Adrian Cursaru
- Bogdan Șerban
- Bogdan Crețu
- Sergiu Iordache
- Corina Silvia Pop
- Cătălin Cîrstoiu
- Ruxandra Ionescu
View Affiliations / Copyright

Affiliations: Department of Internal Medicine and Rheumatology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania

Copyright: © Creţu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Article Number: 1027
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Published online on: July 16, 2021

https://doi.org/10.3892/etm.2021.10459
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Abstract

Immunotherapy has revolutionized cancer treatment. Immune checkpoint inhibitors (ICIs) including antibodies targeting cytotoxic T lymphocyte associated antigen‑4 and programmed cell death 1 have been shown to be effective in the treatment of certain types of cancer. The benefit of these therapies is to prolong life expectancy in the case of metastatic malignancies. Rheumatic adverse events are not very common. In the present study, 9 patients were monitored between November 2018 and January 2020. The oncologist, who identified the occurrence of rheumatic toxicities after the treatment with ICIs, evaluated the patients. Only oncological patients with rheumatic manifestations after the start of immunotherapy were included. Toxicity grading was performed by both the oncologist and the rheumatologist, on a scale from 1 to 5 (1, mild; 2, moderate; 3, severe; 4, life‑threatening; 5, death related to toxicity). The results showed that rheumatoid factor, which was sampled in each patient, was negative in all cases. Patients were treated with nonsteroidal anti‑inflammatory drugs or prednisone depending on the severity of the adverse events. The results varied with the severity of the adverse events. In conclusion, as the number of patients treated with ICIs increases, so will the number of patients presenting with immune‑related adverse events (irAEs). The collaboration between oncologists and rheumatologists should be intimate to provide optimal treatment to patients. Musculoskeletal manifestations secondary to ICIs are slightly different from other rheumatologically conditions making diagnosis, treatment and monitoring difficult. Thus, irAEs are new and challenging for oncologists, thus understanding of the pathogenesis and clinical characteristics must be improved for better treatment guidelines.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Musculoskeletal adverse reactions after immunotherapy for cancer: A case series

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