免疫检查点抑制剂（ICIs）显着改善了癌症患者的预后。然而，这些疗法与不良事件相关，包括从头免疫相关的不良事件或预先存在的自身免疫性疾病的发作。高达 80% 的癌症患者和既往患有银屑病 (PsO) 或银屑病关节炎 (PsA) 的患者在开始 ICI 后会出现 PsO/PsA 发作。靶向白细胞介素 (IL)-17/IL-23 轴是 PsO/PsA 治疗的主流。然而，这种治疗是否可以通过 ICI 暴露有效控制 PsO/PsA，同时保留抗肿瘤功效仍然未知。我们报告了三名患有 PsA 和癌症的患者，他们接受了 ICI 进行癌症治疗。所有患者均为男性。两名患者患有透明细胞肾细胞癌，一名患者患有黑色素瘤。两名患者接受抗 PD-1 抗体单一治疗，一名患者接受抗 CTLA-4 和 PD-1 抗体联合治疗。一名患者一直在接受抗 IL-17A 抗体（苏金单抗）治疗，而另外两名患者在 ICI 治疗期间银屑病关节炎发作后开始接受抗 IL-17A 抗体（ixekizumab）和抗 IL-23 抗体（guselkumab）治疗。值得注意的是，通过抗 IL-17A 或抗 IL-23 抗体治疗，他们的 PsA 仍处于缓解状态，并且他们对 ICI 治疗的耐受性良好。重要的是，所有三名患者均对 ICI 治疗表现出持续的肿瘤反应，分别包括两名完全缓解和一名疾病稳定。这三例病例表明，针对癌症和前期患者，靶向 IL-17/23 轴可能是一种有效且安全的方法。 -现有 PsA 正在考虑进行 ICI 治疗。© 作者（或其雇主）2024。根据 CC BY-NC 允许重复使用。禁止商业再利用。请参阅权利和权限。英国医学杂志出版。

Immune checkpoint inhibitors (ICIs) have significantly improved outcomes for patients with cancer. However, these therapies are associated with adverse events including de novo immune-related adverse events or flare of pre-exiting autoimmune disorders. Up to 80% of patients with cancer and pre-existing psoriasis (PsO) or psoriatic arthritis (PsA) experience PsO/PsA flare after initiating ICIs. Targeting the interleukin (IL)-17/IL-23 axis is a mainstream of the PsO/PsA treatment. However, whether this treatment can effectively control PsO/PsA with ICI exposure while preserving anti-tumour efficacy remains unknown.We report three patients with PsA and cancer, who received ICIs for their cancer treatment. All patients were male. Two patients had clear cell renal cell carcinoma, and one had melanoma. Two patients received anti-PD-1 antibody monotherapy, while one patient received combined anti-CTLA-4 and PD-1 antibody therapy. One patient had been receiving anti-IL-17A antibody (secukinumab), while the other two patients started anti-IL-17A antibody (ixekizumab) and anti-IL-23 antibody (guselkumab) after their PsA flared up during ICI treatment. Of note, with the anti-IL-17A or anti-IL-23 antibody treatment, their PsA remained in remission, and they well tolerated the ICI therapy. Importantly, all three patients showed persistent tumour responses to ICI therapy, including two complete remissions and one stable disease, respectively.These three cases suggest that targeting the IL-17/23 axis may be an effective and safe approach for patients with cancer and pre-existing PsA being considered for ICI therapy.© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.