Selva-O'Callaghan Albert, Trallero-Araguás Ernesto, Ros Javier, Gil-Vila Albert, Lostes Julia, Agustí Antonia, Riera-Arnau Judit, Alvarado-Cárdenas Marcelo, Pinal-Fernandez Iago
Systemic Autoimmune Diseases Unit, Internal Medicine Dept, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
Rheumatology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
Curr Treatm Opt Rheumatol. 2022;8(4):91-104. doi: 10.1007/s40674-022-00197-2. Epub 2022 Oct 21.
Cancer-associated myositis (CAM) is defined as when cancer appears within 3 years of myositis onset. Dermatomyositis and seronegative immune-mediated necrotizing myopathy are the phenotypes mostly related to cancer. In general, treatment principles in myositis patients with and without CAM are similar. However, some aspects of myositis management are particular to CAM, including (a) the need for a multidisciplinary approach and a close relationship with the oncologist, (b) the presence of immunosuppressive and antineoplastic drug interactions, and (c) the role of the long-term immunosuppressive therapy as a risk factor for cancer relapse or development of a second neoplasm. In this review, we will also discuss immunotherapy in patients treated with checkpoint inhibitors as a treatment for their cancer.
Studies on cancer risk in patients treated with long-term immunosuppressive drugs, in autoimmune diseases such as systemic lupus erythematosus or rheumatoid arthritis, and in solid organ transplant recipients have shed some light on this topic. Immunotherapy, which has been a great advance for the treatment of some types of malignancy, may be also of interest in CAM, given the special relationship between both disorders.
Management of CAM is a challenge. In this complex scenario, therapeutic decisions must consider both diseases simultaneously.
The online version contains supplementary material available at 10.1007/s40674-022-00197-2.
癌症相关性肌炎（CAM）定义为癌症在肌炎发病3年内出现。皮肌炎和血清阴性免疫介导的坏死性肌病是与癌症最相关的表型。一般来说，有或没有CAM的肌炎患者的治疗原则相似。然而，CAM患者的肌炎管理在某些方面有其特殊性，包括（a）需要多学科方法以及与肿瘤学家密切合作，（b）存在免疫抑制药物和抗肿瘤药物相互作用，以及（c）长期免疫抑制治疗作为癌症复发或发生第二种肿瘤的危险因素的作用。在本综述中，我们还将讨论接受检查点抑制剂治疗癌症的患者的免疫疗法。
关于长期接受免疫抑制药物治疗的患者、自身免疫性疾病（如系统性红斑狼疮或类风湿性关节炎）患者以及实体器官移植受者的癌症风险的研究为该主题提供了一些线索。免疫疗法在某些类型恶性肿瘤的治疗方面取得了重大进展，鉴于这两种疾病之间的特殊关系，它在CAM中可能也具有重要意义。
CAM的管理是一项挑战。在这种复杂情况下，治疗决策必须同时考虑两种疾病。
在线版本包含可在10.1007/s40674-022-00197-2获取的补充材料。
