Leveraging immune checkpoint inhibitors in lung cancer patients with pre-existing autoimmune disease: clinical insights, optimal timing, and predictive biomarkers for optimal treatment outcomes

The use of immune checkpoint inhibitors (ICIs) has revolutionized cancer treatment, particularly in lung cancer. However, their use in patients with pre-existing autoimmune diseases (PADs) presents unique challenges. PADs, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and pso...

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Main Authors: Hui Yang, Sheng Yu, Hong Ge
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1539260/full
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author Hui Yang
Hui Yang
Sheng Yu
Sheng Yu
Hong Ge
Hong Ge
author_facet Hui Yang
Hui Yang
Sheng Yu
Sheng Yu
Hong Ge
Hong Ge
author_sort Hui Yang
collection DOAJ
description The use of immune checkpoint inhibitors (ICIs) has revolutionized cancer treatment, particularly in lung cancer. However, their use in patients with pre-existing autoimmune diseases (PADs) presents unique challenges. PADs, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and psoriasis, complicate the clinical management of lung cancer due to concerns about worsening autoimmune symptoms during ICI therapy. This review summarized the safety and efficacy of ICIs in lung cancer patients with PAD, focusing on the available clinical evidence, the optimal timing of ICI initiation, and the potential predictive biomarkers for immune-related adverse events (irAEs). Future prospective studies are needed to establish definitive guidelines for the use of ICIs in this population, with a focus on identifying patients at risk, managing ICI resumption after irAE and developing new medications with durable control of both cancer and PAD.
format Article
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institution Kabale University
issn 1664-3224
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publishDate 2025-05-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Immunology
spelling doaj-art-6e7c370d96eb4c1ca37eeb14e8e051e22025-08-20T03:47:41ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-05-011610.3389/fimmu.2025.15392601539260Leveraging immune checkpoint inhibitors in lung cancer patients with pre-existing autoimmune disease: clinical insights, optimal timing, and predictive biomarkers for optimal treatment outcomesHui Yang0Hui Yang1Sheng Yu2Sheng Yu3Hong Ge4Hong Ge5Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, ChinaLaboratory of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, ChinaLaboratory of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, ChinaLaboratory of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, ChinaThe use of immune checkpoint inhibitors (ICIs) has revolutionized cancer treatment, particularly in lung cancer. However, their use in patients with pre-existing autoimmune diseases (PADs) presents unique challenges. PADs, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and psoriasis, complicate the clinical management of lung cancer due to concerns about worsening autoimmune symptoms during ICI therapy. This review summarized the safety and efficacy of ICIs in lung cancer patients with PAD, focusing on the available clinical evidence, the optimal timing of ICI initiation, and the potential predictive biomarkers for immune-related adverse events (irAEs). Future prospective studies are needed to establish definitive guidelines for the use of ICIs in this population, with a focus on identifying patients at risk, managing ICI resumption after irAE and developing new medications with durable control of both cancer and PAD.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1539260/fulllung cancerimmune checkpoint inhibitors (ICBs)immune-related adverse events (IRAE)autoimmune disease (AD)flarepredictive biomarker
spellingShingle Hui Yang
Hui Yang
Sheng Yu
Sheng Yu
Hong Ge
Hong Ge
Leveraging immune checkpoint inhibitors in lung cancer patients with pre-existing autoimmune disease: clinical insights, optimal timing, and predictive biomarkers for optimal treatment outcomes
Frontiers in Immunology
lung cancer
immune checkpoint inhibitors (ICBs)
immune-related adverse events (IRAE)
autoimmune disease (AD)
flare
predictive biomarker
title Leveraging immune checkpoint inhibitors in lung cancer patients with pre-existing autoimmune disease: clinical insights, optimal timing, and predictive biomarkers for optimal treatment outcomes
title_full Leveraging immune checkpoint inhibitors in lung cancer patients with pre-existing autoimmune disease: clinical insights, optimal timing, and predictive biomarkers for optimal treatment outcomes
title_fullStr Leveraging immune checkpoint inhibitors in lung cancer patients with pre-existing autoimmune disease: clinical insights, optimal timing, and predictive biomarkers for optimal treatment outcomes
title_full_unstemmed Leveraging immune checkpoint inhibitors in lung cancer patients with pre-existing autoimmune disease: clinical insights, optimal timing, and predictive biomarkers for optimal treatment outcomes
title_short Leveraging immune checkpoint inhibitors in lung cancer patients with pre-existing autoimmune disease: clinical insights, optimal timing, and predictive biomarkers for optimal treatment outcomes
title_sort leveraging immune checkpoint inhibitors in lung cancer patients with pre existing autoimmune disease clinical insights optimal timing and predictive biomarkers for optimal treatment outcomes
topic lung cancer
immune checkpoint inhibitors (ICBs)
immune-related adverse events (IRAE)
autoimmune disease (AD)
flare
predictive biomarker
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1539260/full
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