{
  "abstract": "Introduction Although immune checkpoint inhibitors (ICIs) have revolutionized the field of oncology and improved patient outcomes, they are also associated with a myriad of inflammatory conditions known as immune related adverse events (irAEs). IrAEs can be de novo or flare-ups of pre-existing autoimmune disorders. One rare rheumatological irAE, though likely underreported, is Raynaud’s phenomenon (RP). RP can be primary or secondary. Primary RP usually occurs alone, whereas secondary RP, often due to endothelial dysfunction, usually develops later in life and can be a harbinger of an autoimmune connective tissue disorder, particularly systemic sclerosis (SSc).Material and Methods This is a case series of five patients who had experienced ICI-induced RP and were evaluated by rheumatology at a cancer center within the past 3 years where their cancers, type of ICIs, diagnostic tests, and treatments are discussed in detail. Biomarkers such as inflammatory markers including erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), interleukin-6 (IL6), interferon gamma (IFN- gamma), and tumor necrosis factor alpha (TNF- alpha) were also collected.Results Our five patients had a wide spectrum of outcomes with respect to their ICI-induced RP. While some patients only had mild symptoms that were managed without medications, others had more severe symptoms which required more aggressive treatments. In addition, some patients were found to have concurrent thromboses. Interestingly, IL-6 and IFN- gamma appear to be the two most likely elevated cytokines in the patients.Conclusions This is the first case series to describe ICI-induced RP, which is likely underreported, where cytokines were checked. Clinically, our cases illustrate the importance of early recognition and treatment of RP while ruling out comorbid conditions that may exacerbate ischemia. The cytokine pattern that we observed is also interesting as it may provide a clue to understanding RP’s pathogenesis, which may not only help oncological rheumatology patients but also be used to elucidate secondary RP in autoimmune rheumatological conditions.Abstract P.194 Table 1Autoimmune serum work-up for patients",
  "authors": [
    {
      "affiliations": [
        "University of Texas MD Anderson Cancer Center, Houston, USA"
      ],
      "name": "Jeff Li"
    },
    {
      "affiliations": [
        "University of Texas MD Anderson Cancer Center, Houston, USA"
      ],
      "name": "Maryam Buni"
    },
    {
      "affiliations": [
        "University of Texas MD Anderson Cancer Center, Houston, USA"
      ],
      "name": "Huifang Lu"
    },
    {
      "affiliations": [
        "University of Texas MD Anderson Cancer Center, Houston, USA"
      ],
      "name": "Jean Tayar"
    },
    {
      "affiliations": [
        "UTHealth McGovern Medical School, Houston, USA"
      ],
      "name": "Shervin Assassi"
    }
  ],
  "title": "P.194 Raynaud’s phenomenon in the setting of immune checkpoint inhibitors: a case series and possible implications",
  "uid": "7f102803-0d60-5732-9b95-974a0618e8e1"
}