Albert Selva-O'Callaghan1, Xavier Martinez-Gómez2, Ernesto Trallero-Araguás3, Iago Pinal-Fernández4. 1. Systemic Autoimmune Diseases Unit, Medicine Department. 2. Preventive Medicine and Epidemiology, Vall d'Hebron General Hospital, Universitat Autònoma de Barcelona. 3. Rheumatology Unit, Vall d'Hebron General Hospital, Barcelona, Spain. 4. Muscle Diseases Unit, NIAMS, National Institutes of Health, Bethesda, Maryland, USA.
Abstract
PURPOSE OF REVIEW: Despite the well-recognized association between malignancy and myositis, definite data indicating the best strategy for diagnosing cancer in myositis patients is lacking. In this article, we review the data on cancer screening in patients with myositis, and propose an algorithm for this purpose based on recently published data. RECENT FINDINGS: Evidence has recently emerged supporting blind screening in patients with certain myositis phenotypes. In addition to the clinical examination, imaging techniques such as PET/computed tomography scanning and whole-body MRI, and determination of the autoantibody profile beyond anti-TIF1γ antibody, the well known cancer biomarker in dermatomyositis, will help the clinician face this complex clinical situation. Molecules related to the checkpoint inhibitor pathway, specifically soluble programmed death 1, may also have a role in the diagnostic work-up of cancer in myositis. In the future, blood tests analysing circulating DNA will certainly help in detecting patients with cancer-associated myositis (CAM). SUMMARY: A step forward has been achieved in the pathway to establish optimal cancer screening for myositis patients. International consensus guidelines for an effective diagnostic work-up of CAM are in progress and will be of paramount importance to improving the outcome in these patients.
PURPOSE OF REVIEW: Despite the well-recognized association between malignancy and myositis, definite data indicating the best strategy for diagnosing cancer in myositispatients is lacking. In this article, we review the data on cancer screening in patients with myositis, and propose an algorithm for this purpose based on recently published data. RECENT FINDINGS: Evidence has recently emerged supporting blind screening in patients with certain myositis phenotypes. In addition to the clinical examination, imaging techniques such as PET/computed tomography scanning and whole-body MRI, and determination of the autoantibody profile beyond anti-TIF1γ antibody, the well known cancer biomarker in dermatomyositis, will help the clinician face this complex clinical situation. Molecules related to the checkpoint inhibitor pathway, specifically soluble programmed death 1, may also have a role in the diagnostic work-up of cancer in myositis. In the future, blood tests analysing circulating DNA will certainly help in detecting patients with cancer-associated myositis (CAM). SUMMARY: A step forward has been achieved in the pathway to establish optimal cancer screening for myositispatients. International consensus guidelines for an effective diagnostic work-up of CAM are in progress and will be of paramount importance to improving the outcome in these patients.
Authors: Adelle S Jee; Robert Sheehy; Peter Hopkins; Tamera J Corte; Christopher Grainge; Lauren K Troy; Karen Symons; Lissa M Spencer; Paul N Reynolds; Sally Chapman; Sally de Boer; Taryn Reddy; Anne E Holland; Daniel C Chambers; Ian N Glaspole; Helen E Jo; Jane F Bleasel; Jeremy P Wrobel; Leona Dowman; Matthew J S Parker; Margaret L Wilsher; Nicole S L Goh; Yuben Moodley; Gregory J Keir Journal: Respirology Date: 2020-11-24 Impact factor: 6.424
Authors: Alexander Oldroyd; Jamie C Sergeant; R Paul New; Neil J McHugh; Zoe Betteridge; Janine A Lamb; William E Ollier; Robert G Cooper; Hector Chinoy Journal: Rheumatology (Oxford) Date: 2019-11-01 Impact factor: 7.580