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Chanson N, Ramos-Casals M, Pundole X, et al. Immune checkpoint inhibitor-associated sarcoidosis: A usually benign disease that does not require immunotherapy discontinuation. Eur J Cancer. 2021;158:208-216doi: 10.1016/j.ejca.2021.05.041.
Chanson, N., Ramos-Casals, M., Pundole, X., Suijkerbuijk, K., José de Barros E Silva, M., Lidar, M., Benesova, K., Leipe, J., Acar-Denizli, N., Pradère, P., Michot, J. M., Voisin, A. L., Suárez-Almazor, M. E., Radstake, T. R. D., Fernandes Moça Trevisani, V., Schulze-Koops, H., Melin, A., Robert, C., Mariette, X., Baughman, R. P., Lambotte, O. (2021). Immune checkpoint inhibitor-associated sarcoidosis: A usually benign disease that does not require immunotherapy discontinuation. European journal of cancer (Oxford, England : 1990), 158208-216. https://doi.org/10.1016/j.ejca.2021.05.041
Chanson, Noémie, et al. "Immune checkpoint inhibitor-associated sarcoidosis: A usually benign disease that does not require immunotherapy discontinuation." European journal of cancer (Oxford, England : 1990) vol. 158 (2021): 208-216. doi: https://doi.org/10.1016/j.ejca.2021.05.041
Chanson N, Ramos-Casals M, Pundole X, Suijkerbuijk K, José de Barros E Silva M, Lidar M, Benesova K, Leipe J, Acar-Denizli N, Pradère P, Michot JM, Voisin AL, Suárez-Almazor ME, Radstake TRD, Fernandes Moça Trevisani V, Schulze-Koops H, Melin A, Robert C, Mariette X, Baughman RP, Lambotte O. Immune checkpoint inhibitor-associated sarcoidosis: A usually benign disease that does not require immunotherapy discontinuation. Eur J Cancer. 2021 Nov;158:208-216. doi: 10.1016/j.ejca.2021.05.041. Epub 2021 Aug 25. PMID: 34452793.
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Eur J Cancer. 2021 Nov;158:208-216. doi: 10.1016/j.ejca.2021.05.041. Epub 2021 Aug 25.

Immune checkpoint inhibitor-associated sarcoidosis: A usually benign disease that does not require immunotherapy discontinuation.

European journal of cancer (Oxford, England : 1990)

Noémie Chanson, Manuel Ramos-Casals, Xerxes Pundole, Karijn Suijkerbuijk, Milton José de Barros E Silva, Merav Lidar, Karolina Benesova, Jan Leipe, Nihan Acar-Denizli, Pauline Pradère, Jean-Marie Michot, Anne-Laure Voisin, Maria E Suárez-Almazor, Timothy R D Radstake, Virginia Fernandes Moça Trevisani, Hendrik Schulze-Koops, Audrey Melin, Caroline Robert, Xavier Mariette, Robert P Baughman, Olivier Lambotte,

Affiliations

  1. AP-HP.Université Paris-Saclay, Hôpital Bicêtre, Department of Internal Medicine and Clinical Immunology, Le Kremlin Bicêtre, France; Université Paris-Saclay; INSERM; CEA, Centre Immunology of Viral Infections and Autoimmune Diseases, IDMIT Department, IBFJ, Le Kremlin-Bicêtre, France.
  2. Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain; Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain. Electronic address: [email protected].
  3. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  4. Department of Medical Oncology, UMC Utrecht Cancer Center, Utrecht, the Netherlands.
  5. AC Camargo Cancer Center, Brazil.
  6. Rheumatology Unit, Sheba Medical Center, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
  7. Department of Internal Medicin and Rheumatology, Universitätsklinikum Heidelberg, Germany.
  8. Division of Rheumatology, Department of Medicine V, University Hospital Mannheim, Medical Faculty Mannheim of the University Heidelberg, German.
  9. Department of Statistics, Faculty of Science and Letters, Mimar Sinan Fine Arts University, Istanbul, Turkey.
  10. Department of Thoracic Surgery, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France.
  11. Département D'Innovation Thérapeutique et D'Essais Précoces, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, F-94805, France.
  12. Unité Fonctionnelle de Pharmacovigilance, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, F-94805, France.
  13. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  14. Federal University of São Paulo, Sao Paulo, Brazil.
  15. Department of Dermatology, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, F-94805, France.
  16. Université Paris-Saclay; INSERM; CEA, Centre Immunology of Viral Infections and Autoimmune Diseases, IDMIT Department, IBFJ, Le Kremlin-Bicêtre, France; AP-HP.Université Paris-Saclay, Department of Rheumatology, Hôpital Bicêtre, Le Kremlin Bicêtre, France.
  17. Department of Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA.
  18. AP-HP.Université Paris-Saclay, Hôpital Bicêtre, Department of Internal Medicine and Clinical Immunology, Le Kremlin Bicêtre, France; Université Paris-Saclay; INSERM; CEA, Centre Immunology of Viral Infections and Autoimmune Diseases, IDMIT Department, IBFJ, Le Kremlin-Bicêtre, France. Electronic address: [email protected].

PMID: 34452793 DOI: 10.1016/j.ejca.2021.05.041

Abstract

OBJECTIVE: To analyse the clinical patterns of sarcoidosis triggered by immune checkpoint inhibitors (ICIs) in patients with cancer.

PATIENTS AND METHODS: The ImmunoCancer International Registry is a big data-sharing multidisciplinary network from 18 countries dedicated to evaluating the clinical research of immune-related adverse events related to cancer immunotherapies.

RESULTS: We identified 32 patients with biopsy-proven sarcoidosis. Underlying cancer included mainly melanoma (n = 24). Cancer immunotherapy consisted of monotherapy in 19 cases (anti-PD-1 in 18 and ipilimumab in 1) or combined ipilimumab + nivolumab in 13. The time median interval between initiation of ICI and sarcoidosis diagnosis was 3 months (range, 2-29 months). The use of combined ICI was associated with a shorter delay in developing sarcoidosis symptoms. The disease was symptomatic in 19 (59%) cases with mostly cutaneous, respiratory and general symptoms. The organs involved included mainly the mediastinal lymph nodes (n = 32), the lungs (n = 11), the skin (n = 10) and the eyes (n = 5). Pulmonary computed tomography studies showed bilateral hilar lymphadenopathy in all cases. There was no severe manifestation. Specific systemic therapy was required in only 12 patients (37%): oral glucocorticoids in 9, and hydroxychloroquine in 3. ICIs were held in 25 patients (78%) and definitively discontinued in 18 (56%) patients. Seven patients continued ICI treatment with a second flare in one case. In six additional patients, an ICI was reintroduced with no harm, and sarcoidosis relapsed in one of them.

CONCLUSION: Our study shows that ICI-related sarcoidosis seems to have a specific profile, possibly more benign than that of idiopathic sarcoidosis, and does not necessarily imply ICI discontinuation.

Copyright © 2021 Elsevier Ltd. All rights reserved.

Keywords: Immune checkpoint inhibitor; Immune related adverse event; Immunotherapy; Readministration; Sarcoidosis

Conflict of interest statement

Conflict of interest statement Prof Olivier Lambotte was paid for expert testimony by and received consultancy fees from BMS France, MSD and Astra Zeneca; received consultancy fees from Incyte; gave e

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