Rheumatic Diseases and Syndromes Induced by Cancer Immunotherapy. A Handbook for Diagnosis and Management

Introduction
Contents
Contributors
Part I: Introduction
	Chapter 1: Cancer Immunology and the Evolution of Immunotherapy
		Cancer Immunology: Immunoediting Hypothesis
		Elimination
		Equilibrium
		Escape
		Cancer Immunotherapy
		Immune Checkpoint Inhibitors
		Cytokines
		Cancer Vaccines
		Adoptive Cell Therapy
		Epigenetic Drugs
		Future of Cancer Immunotherapy
		References
	Chapter 2: Cancer Immunotherapy: Overview of Immune Checkpoint Inhibitors
		CTLA-4 Inhibitors
		PD-1 and PD-L1 Inhibitors
			PD-1 Inhibitors
				Pembrolizumab
				Nivolumab
				Cemiplimab
			PDL-1 Inhibitors
				Atezolizumab
				Durvalumab
				Avelumab
		Combination Immunotherapy
		References
	Chapter 3: Immunopathogenesis of Immune-Related Adverse Events from Cancer Immunotherapy
		Autoimmunity or Autoinflammation?
		Putative Mechanisms of Immunopathogenesis
			Preclinical Models
			Lessons from Primary Immunodeficiency States
			Drugs and Disease Effects
		Basic Mechanisms of Autoimmunity and Autoinflammation for Checkpoint Inhibitors
			Experimental Construct for the Evolution of Autoimmune Diseases
		Proposed Immunologic Pathways Contributing to irAEs
			Generalized Immune Activation
			Direct Off-Target Effects of ICIs
			Preexisting Asymptomatic Autoimmunity
			Off-Target Effects of T Cell-Mediated Immunity
		Genetic and Environmental Factors
		Clinical Implications and Summary
		References
Part II: Immune-Related Adverse Events with Immune-Checkpoint Inhibitors
	Chapter 4: Immune-Related Adverse Events with Immune Checkpoint Inhibitors: Arthritis
		Introduction
		Epidemiology
		Pathogenesis
		Clinical Manifestations
		Diagnosis
			Laboratory Testing
			Imaging
			Differential Diagnosis
		Management
			Immunosuppression and Tumor Response
		Prognosis
		Conclusions and Future Directions
		Case Study
		References
	Chapter 5: Immune-Related Adverse Events with Immune Checkpoint Inhibitors: Polymyalgia Rheumatica
		Introduction
		Epidemiology
		Pathogenesis
		Clinical Manifestations
		Diagnosis
			Differential Diagnosis
		Management
		Conclusions and Future Directions
		Case Study
		References
	Chapter 6: Myositis
		Introduction
		Epidemiology
		Pathogenesis
		Clinical Manifestations
		Diagnosis
		Differential Diagnosis
		Management
		Conclusions and Future Directions
		Case Study
		References
	Chapter 7: Sicca Syndromes
		Introduction
		Epidemiology
		Pathogenesis
		Histopathology
		Literature Review of Reported Cases
		Subsets of ICI-Induced Sicca
			De novo Development of Oral and/or Ocular Dryness Without Systemic Manifestations
			De Novo Development of Oral and/or Ocular Dryness with Systemic Manifestations
			Flare of a Recognized Preexisting Rheumatic Disease, Associated with Ocular and Oral Dryness
		Clinical Manifestations
		Diagnosis
		Differential Diagnosis
		Management
			ICI-Induced Sicca Without Systemic Symptoms
			ICI-Induced Sicca with Systemic Symptoms
			ICI-Induced Sicca in the Setting of Preexisting Rheumatic Disease
		Conclusions and Future Directions
		Case Study
		References
	Chapter 8: Sarcoidosis
		Introduction
		Epidemiology
		Pathogenesis
		Clinical Manifestations
		Diagnosis
		Differential Diagnosis
			Drug-Induced Pneumonitis
			Cancer Progression
			Infection
		Management
		Prognosis
		Conclusions and Future Directions
		Case Study
		References
	Chapter 9: Miscellaneous Rheumatic Syndromes
		Introduction
		Vasculitis
			Large Vessel Vasculitis
			Vasculitis of the Nervous System
			Other Vasculitides
		Systemic Lupus Erythematosus
		Scleroderma
		Eosinophilic Fasciitis
		Conclusions and Future Directions
		References
	Chapter 10: Non-Rheumatic Immune-Related Adverse Events
		Introduction
		Neurologic Immune-Related Adverse Events
		Acute Encephalitis
		Peripheral Neuropathy and Guillain-Barre Syndrome
		Myasthenia Gravis
		Ophthalmic irAEs: Uveitis
		Pulmonary irAEs: Pneumonitis
		Gastrointestinal irAEs
		Colitis
		Immune-Related Hepatitis
		Immune-Related Pancreatitis
		Hematologic irAEs: Immune-Related Thrombocytopenia
		Cardiovascular irAEs: Myocarditis and Pericarditis
		Dermatologic irAEs: Maculopapular Dermatitis and Pruritus
		Renal irAEs
		Endocrine irAEs: Hypophysitis, Hypothyroidism, and Type 1 Diabetes Mellitus
		Conclusions and Future Directions
		References
	Chapter 11: Immune-Related Adverse Events with Other Cancer Immunotherapies
		Adoptive Cell Therapies: Chimeric Antigen Receptor T-Cell (CAR-T) Therapy
			Cytokine Release Syndrome
			Immune Effector Cell-Associated Neurotoxicity Syndrome
		Cytokines
			Recombinant Interferon-Alpha
			Recombinant Interleukin-2 Therapy
				Vascular Leak Syndrome
				Myocarditis
		Vaccines
			Sipuleucel-T
		Mycobacterium bovis Bacillus Calmette-Guérin (BCG)
		Conclusions and Future Directions
		References
Part III: Cancer Immunotherapy in Patients with Pre-existing Rheumatic Diseases
	Chapter 12: Cancer Immunotherapy in Patients with Preexisting Inflammatory Arthritis
		Introduction
		Epidemiology
			Rheumatoid Arthritis
			Spondyloarthritis
		Pathogenesis
		Case Study
		Management
		References
	Chapter 13: Cancer Immunotherapy in Patients with Preexisting Rheumatic Diseases: Other Rheumatic Autoimmune Diseases
		Introduction
		Epidemiology
		Clinical Manifestations
		Diagnosis
		Management
			General Considerations
			Baseline Evaluation and Immunosuppressive Regimen
			Flare and/or irAE Management
		Conclusion
		Case Study
		References
Part IV: General Principles of Management
	Chapter 14: Management of Rheumatic Immune-Related Adverse Events (irAEs): General Principles
		Introduction
		Guidelines
		ASCO/SITC Guidelines
		General Principles of Immunosuppression for Rheumatic irAEs: Targeted Therapies
			Anti-TNF-Directed Therapies
			Anti-IL-6-Directed Therapies
			Anti-IL-1-Directed Therapies
			Anti-IL-17-Directed Therapies
			Anti-B-Cell-Directed Therapies
			Janus Kinase Inhibitors (Jak-i)
			Abatacept
		Conclusions
		References
	Chapter 15: Benefit-Risk Considerations
		Evaluating the Potential Benefits and Risks of Therapies
			Benefits
				Types of Benefits
				Magnitude of Effect
				Duration
				Likelihood of Patients Experiencing a Benefit
				Medical Need
				Patient Values and Preferences
			Harms
				Types of Harms
				Severity and Impact
				Duration
				Likelihood of Risk
				Patient Tolerance of Risk and Uncertainty
		Multidisciplinary Approach
		Case Studies
		Conclusions and Future Directions
		References
	Chapter 16: Patient Education and Shared Decision-Making
		Patient Education
		Learning Needs
		Education Strategies
			Assessment of Health Literacy
			Patients’ Values
			Shared Decision-Making
			Forms of Health Communication
			Discredit False Information
			Discussing Immune-Related Adverse Events Management Plans
		Conclusions and Future Directions
		References
Index