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The evolving role of the rheumatologist in the management of immune-related adverse events (irAEs) caused by cancer immunotherapy
  1. Leonard Calabrese1,
  2. Xavier Mariette2,3,4
  1. 1 Department of Rheumatology/Immunology, Cleveland Clinic, Cleveland, Ohio, USA
  2. 2 Department of Rheumatology, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, France
  3. 3 Université Paris-Sud, Le Kremlin Bicêtre, France
  4. 4 IMVA Center, INSERM, Le Kremlin Bicêtre, France
  1. Correspondence to Dr Leonard Calabrese, Department of Rheumatology/Immunology, Cleveland Clinic, Cleveland, OH 44195, USA; calabrl{at}


The rapid introduction of immunotherapies for cancer-targeting immunological checkpoints has led to a new class of toxicities that appear to be of autoimmune and or autoinflammatory origin. These disorders are now referred to as immune-related adverse events (irAEs) and pose considerable challenges to patient care in terms of how to optimally manage these formidable toxicities while allowing effective antitumoural therapy to continue. While rheumatologists will naturally be called on to manage those irAEs of rheumatic origin, we believe there is a need and an opportunity for rheumatologists to participate as central figures in this evolving field, in large part because of our familiarity with multiorgan autoimmune disease and our expertise in crafting and utilising both traditional and biological immune-based therapies. Rheumatologists urgently need education in this evolving field to be best positioned as contributors to care of such patients and investigators of the underlying mechanisms of these complications.

  • autoimmunity
  • autoimmune diseases
  • treatment

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  • LC and XM contributed equally.

  • Handling editor Tore K Kvien

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.