TNF in the era of immune checkpoint inhibitors: Friend or foe? Review


Authors: Chen, A. Y.; Wolchok, J. D.; Bass, A. R.
Review Title: TNF in the era of immune checkpoint inhibitors: Friend or foe?
Abstract: Immune checkpoint inhibitors (ICIs) are effective in the treatment of patients with advanced cancer and have emerged as a pillar of standard cancer care. However, their use is complicated by adverse effects known as immune-related adverse events (irAEs), including ICI-induced inflammatory arthritis. ICI-induced inflammatory arthritis is distinguished from other irAEs by its persistence and requirement for long-term treatment. TNF inhibitors are commonly used to treat inflammatory diseases such as rheumatoid arthritis, spondyloarthropathies and inflammatory bowel disease, and have also been adopted as second-line agents to treat irAEs refractory to glucocorticoid treatment. Experiencing an irAE is associated with a better antitumour response after ICI treatment. However, whether TNF inhibition can be safely used to treat irAEs without promoting cancer progression, either by compromising ICI therapy efficacy or via another route, remains an open question. In this Review, we discuss clinical and preclinical studies that address the relationship between TNF, TNF inhibition and cancer. The bulk of the evidence suggests that at least short courses of TNF inhibitors are safe for the treatment of irAEs in patients with cancer undergoing ICI therapy. Data from preclinical studies hint that TNF inhibition might augment the antitumour effect of ICI therapy while simultaneously ameliorating irAEs. © 2021, Springer Nature Limited.
Keywords: review; cancer risk; drug efficacy; antineoplastic activity; immune response; antiinflammatory activity; tumor necrosis factor inhibitor; rheumatic disease; human; priority journal; malignant neoplasm
Journal Title: Nature Reviews Rheumatology
Volume: 17
Issue: 4
ISSN: 1759-4790
Publisher: Nature Publishing Group  
Date Published: 2021-04-01
Start Page: 213
End Page: 223
Language: English
DOI: 10.1038/s41584-021-00584-4
PUBMED: 33686279
PROVIDER: scopus
DOI/URL:
Notes: Review -- Export Date: 3 May 2021 -- Source: Scopus
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  1. Jedd D Wolchok
    820 Wolchok