Breaking News: Immunotherapy Drugs Cause Autoimmune Diseases in Some Patients

[Gemini]

A new class of cancer drugs, antibodies that block T-cell receptors (PD-1, CTLA-4) and unleash T-cells against tumors, are causing rapid onset type 1 diabetes and other autoimmune diseases in some patients.

Heralded as the 2013 "Breakthrough of the Year" these drugs have delivered impressive results.

Researchers are rushing to determine which patients receiving checkpoint inhibitors are at high risk and to learn how this unusual side effect causes autoimmune disease.

"These [patients] are human experiments of the autoimmune process."

Source: 17 Nov 2017, Science Magazine
http://science.sciencemag.org/content/358/6365/852.full

Need to follow this developing story i.e. Ron Davis notes discoveries in one field often benefit another.

@Janet Dafoe (Rose49)

 

[Londinium]

Interesting. I had already thought that autoimmunity was a known risk of PD-1 inhibitors, given that one of the main purposes of PD-1 is to down-regulate the immune system.

 

[Gingergrrl]

@Gemini I can't access the article but does it say what the drugs are called that can trigger autoimmunity? Are they chemo drugs or others? Thanks!

 

[Gemini]

Interesting. I had already thought that autoimmunity was a known risk of PD-1 inhibitors, given that one of the main purposes of PD-1 is to down-regulate the immune system.

You're very right @Londinium article notes animal studies(engineered mice) as far back as 2003 suggested an association between PD-1 and diabetes.

And "the diabetes cases are linked almost solely to PD-1 and PD-L1 blockers, other autoimmune conditions have occurred with a different type of checkpoint inhibitor..."

 

[Gemini]

@Gemini I can't access the article but does it say what the drugs are called that can trigger autoimmunity? Are they chemo drugs or others? Thanks!

Sorry, @Gingergrrl was afraid the article might be behind a paywall. Sure wish everything was open access!

No, not chemo, a new class of drugs called checkpoint inhibitors within the broader category of "Immunotherapy."

Article cites one drug ipilimumab, an antibody that blocks the CTLA-4 receptor on T-cells.

It mentions PD-1 and PD-L1 blockers in general. Merck's Keytruda(pembrolizumab) and Bristol Myers' Opdivo(nivolumab) for example are PD-1 blockers. Five checkpoint inhibitors have gone on the market since 2014.

Specific checkpoint inhibitors might be linked to specific autoimmune diseases, like PD-1 inhibitors to Type 1 diabetes.

Other autoimmune diseases mentioned in the article are thyroid disease, colitis, and lymphocytic myocarditis.

 

[Gingergrrl]

Thanks @Gemini and it might not be behind a paywall vs. I just can't access it from my phone where I am right now. The article does not mention Rituximab does it? Just wanted to be sure!

 

[Diwi9]

I have a friend who participated in a new immunotherapy drug for melanoma. My friend has since developed reactive arthritis...would love to get a hold of this article...

 

[Gemini]

I have a friend who participated in a new immunotherapy drug for melanoma. My friend has since developed reactive arthritis...would love to get a hold of this article...

I've a relative on PD-1 blocker Opdivo for lung cancer with excellent results who developed diabetes.

 

[liverock]

http://www.sciencemag.org/news/2017...-can-also-ignite-diabetes-or-other-autoimmune

 

[jpcv]

Thanks @Gemini and it might not be behind a paywall vs. I just can't access it from my phone where I am right now. The article does not mention Rituximab does it? Just wanted to be sure!

No @Gingergrrl , Rituximab is a antibody against Lymphocites B ( CD 20+).
Nivolumab and Pembrozilumab are directed against PDl1 /PD1 , they are ligands /receptors that are involved one of the many ways that cancer cells use to evade from Tcells.
Ipilimumab basically does the same thing, but acts in another receptor.
These drugs "unlock"the immune system, that´s why we see so many autoimmune reactions, some of them can be life threatening, mainly with ipilimumab.

 

[Gingergrrl]

Thank you @jpcv and I did not think there was any relation or connection w/Ritux but just wanted to confirm!

 

[HowToEscape?]

I've a relative on PD-1 blocker Opdivo for lung cancer with excellent results who developed diabetes.

Lung cancer is usually fatal, so the alternatives are not very good. The problem with cancer is that it’s cells of own body that are too aggressive about living. You have to either kill those cells or let them kill you, but since they are your own cells killing them likely involves some harm to your own body.

 

[TreePerson]

I wonder if there is the same female to male ratio in these post cancer cases.