Immune-related adverse events (irAEs) are a major toxicity of immune checkpoint inhibitors. Studies have reported that pre-existing autoimmunity increases the risk of irAEs, but it remains unknown which clinical factors are linked to auto-immune disorders in cancer patients. | Holmes et al. BMC Cancer 2021 21 1300 https s12885-021-09001-1 RESEARCH Open Access Association of advanced age and cancer history with autoimmune disease in melanoma patients a cross-sectional study Aaron N. Holmes1 Helen Swede1 Wendy M. Feer1 Donna Comins Pike1 Xiaoyan Wang1 2 and Upendra P. Hegde1 Abstract Background Immune-related adverse events irAEs are a major toxicity of immune checkpoint inhibitors. Studies have reported that pre-existing autoimmunity increases the risk of irAEs but it remains unknown which clinical factors are linked to auto-immune disorders in cancer patients. This study aimed to evaluate if the prevalence of autoimmune diseases varied by specific cancer history and advanced age. Methods Our cross-sectional medical record review consisted of 291 333 patients age 18 years treated between 2000 and 2018. Patients were classified into four study groups melanoma only non-cutaneous solid cancer only melanoma and non-cutaneous cancer and no cancer history . Dependent variable was the presence of 1 autoim- mune disorders based on 98 conditions using 317 ICD codes. Results Non-cutaneous cancer in the absence or presence of melanoma was associated with a higher prevalence of autoimmunity 95 CI 95 CI respectively compared to the rates in patients with melanoma only and those without cancer history 95 CI 95 CI respectively . Among patients with metastases at initial presentation those in the melanoma and non-cutaneous cancer group had a prevalence of 95 CI compared to 95 CI in those without metastases. Multiple logistic regression demonstrated that patients gt 75 years exhibited the highest odds of autoimmunity relative to other age groups with age 18 34 as the referent OR 95 CI . Conclusions Among patients with melanoma the greatest prevalence of autoimmunity occurred with advanced age and a history of non-cutaneous cancer. Keywords
