Role of IVIG in the Treatment of Autoimmune Conditions With Concurrent Immune Checkpoint Inhibitors for Metastatic Cancer

Immune checkpoint inhibitors (ICIs) are a class of medications targeting mostly the PD-1/PD-L1 and CTLA-4 immune pathways in the treatment of many cancers. Despite the encouraging success of ICIs, they are associated with immune-related adverse events as well as exacerbation of underlying autoimmune conditions. The treatment of these conditions often involves discontinuation of ICI in addition to the utilization of immunomodulatory agents. In this report, we discuss a case in which a patient with metastatic renal cell carcinoma experienced exacerbation of underlying paraneoplastic dermatomyositis after treatment with ICI. He was successfully continued on ICI with the use of intravenous immunoglobulin. The patient experienced adequate control of his myositis but also experienced deepening of his antitumor response.

Automated summary

ICIs are medications targeting immune pathways and have shown success in treating many cancers, but can also lead to immune-related adverse events and worsening of underlying autoimmune conditions. This report discusses a case in which a patient with metastatic renal cell carcinoma experienced exacerbation of paraneoplastic dermatomyositis after ICI treatment and successfully continued with the help of intravenous immunoglobulin.