Summer 2023 (Volume 33, Number 2)
The CRA Practice Reflection Award: Dr. Janet Roberts and
Dr. Carrie Ye
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The use of immune checkpoint
inhibitors (ICI) has steadily increased
over the last decade and
heralded a new era of cancer treatment,
offering hope and significant survival
benefit for many with advanced-stage
malignancies. The interplay between
autoimmunity and cancer has been
magnified with the use of ICI through
the development of off-target effects
termed immune-related adverse events
(irAE). Rheumatologists have now become
an integral part of the oncology
team, often called upon to diagnose
and walk the fine line of managing
these patients with immunosuppression.
As rheumatologists, we are no
strangers to managing rare conditions
or navigating diagnostic uncertainty.
However, the rapidly evolving nature
of this field of medicine has made
it challenging to keep abreast of the
latest literature on this topic. Support
of colleagues and the ability to discuss
difficult cases, particularly with those who see large volumes
of these patients across the world, is paramount in
supporting Canadian rheumatologists who are faced with
the challenges of managing these patients.
The Canadian Research Group of Rheumatology in
Immuno-oncology (CanRIO), with members from nine
academic sites across Canada, has been at the forefront of
both research and educational initiatives in the management
of rheumatic complications of cancer immunotherapy.
Through the assistance of a CIORA grant we have developed
the first online educational platform of its kind (canrio.ca),
with the ultimate goal of improving care of cancer patients
across Canada who develop rheumatic irAE or have
pre-existing rheumatic disease, through collaboration, education,
and research. As part of this educational initiative,
we created five case-based learning modules on the topics
of immune-related arthritis, myositis, vasculitis, sarcoid-like
reactions, and the management of patients with pre-existing
rheumatic diseases. The website also serves as the platform
to register for bi-monthly case-based rounds which offer a
unique opportunity for rheumatologists across Canada to
meet with leading experts around the world to discuss challenging
cases and ultimately learn from each other. We look
forward to building upon the resources developed thus far
to strive to meet the urgent need for education on this topic,
and to ensure Canadian rheumatologists are optimally positioned
to manage this patient population in concert with
our oncology partners.
Janet Roberts, MD, FRCPC
Assistant Professor,
Division of Rheumatology,
Department of Medicine
Dalhousie University,
Halifax, Nova Scotia
Carrie Ye, MD, FRCPC
Clinical Assistant Professor,
University of Alberta
Edmonton, Alberta
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