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Addressing immune-related adverse events of cancer immunotherapy: how prepared are rheumatologists?
  1. Marie Kostine1,
  2. Laura C Cappelli2,
  3. Cassandra Calabrese3,
  4. Leonard H Calabrese3,
  5. Clifton O Bingham III2,
  6. Christophe Richez1,
  7. Jacques-Eric Gottenberg4,
  8. Olivier Lambotte5
  1. 1 Rheumatology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
  2. 2 Rheumatology, Johns Hopkins University, Baltimore, Maryland, USA
  3. 3 Rheumatology/Immunology, Cleveland Clinic, Cleveland, Ohio, USA
  4. 4 Rheumatology, Hopitaux Universitaires de Strasbourg, Strasbourg, France
  5. 5 Internal Medicine and Clinical Immunology, Hopital Bicetre, Le Kremlin-Bicetre, France
  1. Correspondence to Dr Marie Kostine, Rheumatology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux 33000, France; marie.kostine{at}

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Cancer immunotherapy blocking immune checkpoints represents a major advance in oncology. Immune checkpoint inhibitors (ICI) targeting cytotoxic T-lymphocyte-associated antigen 4 and programmed cell death 1 (PD-1) or its ligand PD-L1 have become standard of care in many advanced-stage cancers. Yet an important proportion of patients experience inflammatory or autoimmune side effects, also known as immune-related adverse events (irAEs), as a consequence of dysregulated immunity. irAEs can affect almost any organ system.1 Notably, an expanding range of manifestations mimicking our classical rheumatic diseases have been described.2 3 Rheumatic irAEs, including inflammatory arthritis, pseudomyalgia rheumatica, sicca syndrome, myositis and vasculitis, are increasingly reported. Since there has been increasing emphasis on this emerging field within the last 3 years, we aimed to evaluate the knowledge of rheumatologists, as well as other specialists, regarding ICI and irAEs through an online survey.

Survey questions addressed the demographics (gender, age, practice setting and duration of medical practice), domains of awareness, clinical experience and interest in irAE-specific medical education. The survey was first distributed in the USA (2016) to healthcare provider cohorts at Johns Hopkins University (JHU) and Cleveland Clinic (CC), then in France (2018) to rheumatologists and other specialists via …

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