HealthDay News — For patients with advanced melanoma, response to immune checkpoint inhibitors (ICIs) is similar for those with and without preexisting autoimmune disease (AID), according to a study published online Feb. 16 in the Annals of Internal Medicine.

Monique K. van der Kooij, M.D., from Leiden University Medical Center in the Netherlands, and colleagues conducted a nationwide cohort study in the Netherlands to examine the safety and efficacy of ICIs in 4,367 patients with advanced melanoma with and without AID; 9.5 percent had AID.

The researchers found that for patients with AID, the incidences of immune-related adverse events of grade 3 or higher were 30, 17, and 44 percent for those treated with anti-cytotoxic T lymphocyte-associated protein 4 (CTLA-4), anti-programmed cell death 1 (PD-1), and combination therapy, respectively; for patients without AID, the corresponding incidences were 30, 13, and 48 percent. Compared with patients without AID, those with AID more often discontinued anti-PD-1 treatment because of toxicity (17 versus 9 percent). Anti-PD-1-induced colitis occurred more often in patients with inflammatory bowel disease. Patients with versus without AID who were treated with anti-CTL-4, anti-PD-1, and combination therapy had similar objective response rates (10 versus 16 percent; 40 versus 44 percent; and 39 versus 43 percent, respectively). No difference was seen in survival for those with and without AID (median, 13 versus 14 months).

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“We encourage physicians not to withhold ICI in most common AIDs,” the authors write.

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