Lung Cancer Patients Potentially Unable to Receive Immunotherapy Due to Autoimmune Disease

A recent study found that a large amount of patients with lung cancer also have an autoimmune disease, which could make them ineligible for immunotherapy.

Typically, clinical trials of immunotherapy drugs do not include patients with autoimmune diseases, even though this population includes between 20 to 50 million people in the United States, according to the study published in JAMA Oncology.

"Our team wanted to determine if this practice had a significant impact. The new immunotherapy treatments also convey the risk of unpredictable, possibly severe, and potentially irreversible autoimmune toxicities affecting a variety of organs,” said first author Saad Khan, MD. “With combination immunotherapy regimens, rates of these adverse events may exceed 50%.”

Included in the study were 210,509 patients with lung cancer who were over 65-years-old. Researchers used algorithms to detect the presence of an autoimmune disease. Rheumatoid arthritis, psoriasis, and polymyalgia rheumatic were the most common autoimmune diseases reported.

Researchers found that 14% to 25% of patients with lung cancer also have an autoimmune disease, making them potentially ineligible for immunotherapy treatment.

"Our findings provide the first robust estimate of autoimmune conditions among lung cancer patients," said researcher Sandi Pruitt, PhD. "This study will influence clinical practice and the design of clinical trials, and raise additional research questions of critical importance to lung cancer patients and their doctors."

Researchers believe that advanced age at diagnosis and smoking history could be part of the for a high rate of autoimmune diseases among patients with lung cancer.

"Since the use of cancer immunotherapy is growing, examining the effectiveness and toxicity of these promising treatments among patients with autoimmune diseases will be critical," concluded researcher David Gerber, MD. "While prior research has suggested that administering immune therapy to patients with autoimmune disease may be feasible, doing so carries the risk of making their disease worse, and requires careful monitoring.”