Rheumatic Diseases And Syndromes Induced By Cancer Immunotherapy

With the increasing use of immune checkpoint inhibitors (ICI) across various cancers, the trends for indication at earlier stages, and the use of combination immunotherapy, the frequency of ICI-induced immune-related adverse events (irAE) is expected to grow substantially. Management of these irAE is challenging as it requires not only consideration of the toxicity but also risk-benefit ratios with respect to the primary cancer. Several rheumatic irAE have been reported with ICI therapy including arthritis, myositis, polymyalgia-like syndromes, sicca/Sjogren-like manifestations, and several other less common systemic autoimmune features commonly associated with connective tissue disease. This handbook provides clinicians with a comprehensive overview of the management of rheumatic irAE that develop from cancer immunotherapy. It focuses on the irAE seen with ICI, the most frequently used agents in treating cancer. It provides an overview of cancer immunology, immunotoxicity, and immunotherapies such as ICI, cytokine-based therapy, and CART. It examines the epidemiology, clinical manifestations, diagnosis, differential diagnosis, and treatment of a variety of rheumatic immune-related adverse events arising from these therapies. Chapters also cover cancer immunotherapy in patients with preexisting rheumatic diseases such as inflammatory arthritis and other connective tissue disorders. The book helps clinicians to distinguish the current types of cancer immunotherapy and general toxicity patterns, recognize and diagnose rheumatic clinical syndromes, understand the pathogenesis of irAE, and consider risk–benefit ratios when managing patients with rheumatic irAE. Rheumatic Diseases and Syndromes Induced by Cancer Immunotherapy is an essential resource for physicians and related professionals, residents, fellows, graduate students and nurses alike in rheumatology, clinical immunology, oncology, and internal medicine.

This issue of Rheumatic Disease Clinics, guest edited by Dr. John Davis, will discuss Cancer and Rheumatic Diseases. This issue is one of four selected each year by series Consulting Editor, Dr. Michael Weisman. Topics discussed in this issue include, but are not limited to: rheumatic drugs and malignancy potential, biologic drugs and cancer, methotrexate and cancer, managing rheumatoid arthritis with cancer, Sjogren’s Syndrome and cancer, lupus and cancer, scleroderma and cancer, cancer and spondylarthritis, and cancer immunotherapy.

This issue of Rheumatic Disease Clinics of North America provides foundational and in-depth information about paraneoplastic and cancer treatment-related rheumatic disorders, in which every practicing rheumatologist should be well-versed. Topics covered include neoplasm risk in patients with rheumatic diseases; neoplasm risk of anti-rheumatic therapy; rheumatologic laboratory findings in malignancy; rheumatic manifestations of primary and metastatic bone tumors and paraneoplastic bone disease; neoplastic/paraneoplastic synovitis; neoplastic/paraneoplastic dermatitis, fasciitis, and panniculitis; neoplastic/paraneoplastic vasculitis, vasculopathy, and hypercoagulability; neoplastic/paraneoplastic myalgias and myositis; and less-common neoplastic/paraneoplastic syndromes.

Recent developments in basic science and clinical rheumatology make it appropriate at this time to create a volume devoted to the immunology of rheumatic diseases. The impact of molecular biology, gene cloning, and new technologies for establishing hybridomas and T-cell lines in the laboratory is now beginning to be felt in clinical medicine. There is a general air of excitement and a feeling that we stand on the threshold of a new era in molecular medicine and clinical science. It is this excitement that we have tried to capture in this book. This volume is divided into five sections entitled Basic Mechanisms, Autoimmunity, Classical Concepts of Rheumatic Diseases, Pathogenetic Mechanisms, and Therapy. This is not an arbitrary arrangement but represents our belief that from an understanding of basic mechanisms of disease pathogenesis will come new and more successful forms of treatment for the sufferers of rheumatic disorders. We have tried in the selection of authors to choose internationally recognized experts who have both a scientific and a clinical orientation to their subjects. We believe the marriage of clinical and basic disciplines represents the best hope for rapid knowledge transfer from the laboratory to the clinic, where such knowledge can be used to improve patient health.

This issue of Rheumatic Disease Clinics, guest edited by Dr. John Davis, will discuss Cancer and Rheumatic Diseases. This issue is one of four selected each year by series Consulting Editor, Dr. Michael Weisman. Topics discussed in this issue include, but are not limited to: rheumatic drugs and malignancy potential, biologic drugs and cancer, methotrexate and cancer, managing rheumatoid arthritis with cancer, Sjogren's Syndrome and cancer, lupus and cancer, scleroderma and cancer, cancer and spondylarthritis, and cancer immunotherapy.

In the present monograph, we offer current insights into polymyalgia rheumatica and giant cell arthritis. Both diseases are typical for advanced age, and their incidences increase with aging. Both diseases are a center point of interest not only for rheu- tologists, gerontologists, ophthalmologists or neurologists, but also for general prac- tioners. Early diagnosis and rapid treatment, mainly with glucocorticoids can save one of the most precious senses-vision. Damage to other organs (heart, aorta, co- nary arteries, liver, lungs, kidneys), which are supplied by the arteries affected by ischemic syndrome in the setting of giant cell arthritis, has serious consequences as well. Late diagnosis of giant cell arthritis can have fatal consequences for affected patients. It is a matter of fact that the human population is aging. Therefore, more attention has to be paid not only to diagnosis, clinical course and treatment of rheumatic d- eases in elderly, but also to their genetic, immunologic, endocrinologic, chronobiologic mechanisms, and state-of-the-art diagnostic modalities. I am convinced that the int- disciplinary research of the diseases will allow us to diagnose and treat the rheumatic diseases even faster and more effectively in the future.

This Open Access book presents practical approaches to managing patients affected by various rheumatological diseases, allowing readers to gain a better understanding of the various clinical expressions and problems experienced by these patients. Discussing rheumatology from an organ systems perspective, it highlights the importance ofdetailed musculoskeletal examinations when treating patients affected by rheumatological diseases. The book first explores the latest diagnostic approaches and offers key tips for accurate musculoskeletal examinations before addressing the various treatment modalities, with a particular focus on the most common joints involved in rheumatoid arthritis: the wrists and the metacarpophalangeal joints (2nd and 3rd). Featuring easy-to-understand flow diagrams and explaining the common medical problems associated with rheumatic disease, such as shortness of breath and anemia, it is not only a valuable resource to rheumatologists, but will also appeal to medical students, junior residents, and primary healthcare physicians.

The Society for Immunotherapy of Cancer's handbook,SITC’s Guide to Managing Immunotherapy Toxicity, is a practical reference to managing side effects associated with FDA-approved cancer immunotherapy drugs. Separated into two parts, Part I contains chapter-based overviews of immune checkpoint inhibitors in the clinic, starting with anti-CTLA4 agents, anti-PD1/PD-L1 agents, and approved immunotherapeutic combinations. These chapters cover relevant mechanisms of action, indications, and toxicities seen while combating early, advanced, and metastatic stages in cancer patients. Part II is structured by common and uncommon toxicities that affect major organ sites throughout the body. It begins with a general summary of principles and management options followed by chapters focusing on specific toxicities such as rash and mucosal irritation, muscle and joint toxicity, diarrhea and colitis, pneumonitis, endocrine toxicities, neurological toxicities, cardiac toxicity, renal toxicity, hematologic toxicity, and ocular toxicities. Each chapter provides guidance on how to assess and treat the toxicity and how to support the patient through acute and chronic effects with detailed summary tables for quick reference. Part II concludes with chapters covering management of special patient populations, including patients with autoimmune disease and geriatric patients, treatment and management of fatigue, and a final chapter dedicated to cost effectiveness and the toll of financial toxicity on patients and caregivers. With chapters written by world-recognized leaders in the immuno-oncology field, this text provides thorough coverage of the toxicity and management of adverse effects for immune checkpoint inhibitors. It is an indispensable resource for clinical oncologists, emergency physicians, hospitalists and other medical practitioners in both the hospital and community clinic settings, especially as the use of immune checkpoint inhibitors becomes a fixture in oncology care. Key Features: Outlines strategies for treating high-risk patients facing an acute or chronic side effect to immunotherapy Provides numerous tables that condense and highlight pertinent information for quick reference Describes the various clinical presentations and toxic reactions caused by immunotherapy Purchase includes access to the eBook for use on most mobile devices or computer