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Combining TNF blockade with immune checkpoint inhibitors in patients with cancer

Nature Reviews Rheumatology volume 17, page 577 (2021)Cite this article

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TNF is involved in various autoimmune diseases and in immune-related adverse events (irAEs) that occur in patients with cancer being treated with immune checkpoint inhibitors (ICIs)1,2. In their Review (Chen, A. Y., Wolchok, J. D., & Bass, A. R. TNF in the era of immune checkpoint inhibitors: friend or foe? Nat. Rev. Rheumatol. 17, 213–223 (2021))3, Chen and colleagues nicely reviewed the literature, from basic studies4,5 to clinical observations6,7, discussing whether TNF can be considered as a putative target in the treatment of irAEs in patients with cancer undergoing ICI therapy. Important questions were raised regarding TNF inhibitor safety and efficacy in this setting, but unfortunately, the authors missed out discussions of the TICIMEL phase Ib clinical trial (NTC03293784), the results of which we think help address some of these questions.

Initiated in 2018, the TICIMEL trial investigated the effects of treatment with the ICIs ipilimumab (an anti-CTLA4 antibody) and nivolumab (an anti-PD1 antibody) in combination with a TNF inhibitor (infliximab or certolizumab) in patients with advanced melanoma8. The results from 14 patients enrolled in the first phase of this trial were published in December 2020 (ref.9). Although the low number of patients warrants caution as regard to the interpretation of data, the results are informative.

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Author notes

  1. These authors contributed equally: Nicolas Meyer, Bruno Ségui

Authors and Affiliations

  1. INSERM UMR 1037, Cancer Research Center of Toulouse (CRCT), Toulouse, France

    Anne Montfort, Mathieu Virazels, Céline Colacios, Nicolas Meyer & Bruno Ségui

  2. Equipe Labellisée Fondation ARC pour la recherche sur le cancer, Toulouse, France

    Anne Montfort, Mathieu Virazels, Céline Colacios, Nicolas Meyer & Bruno Ségui

  3. Université Toulouse III - Paul Sabatier, Toulouse, France

    Mathieu Virazels, Céline Colacios, Nicolas Meyer & Bruno Ségui

  4. Service d’Oncodermatologie, Institut Universitaire du Cancer (IUCT-O), CHU de Toulouse, Toulouse, France

    Nicolas Meyer

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  1. Anne Montfort
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  2. Mathieu Virazels
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  3. Céline Colacios
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  4. Nicolas Meyer
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Corresponding authors

Correspondence to Nicolas Meyer or Bruno Ségui.

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Competing interests

B.S. has worked as investigator, consultant and speaker for BMS. N.M. has worked as investigator and/or consultant and/or speaker for BMS, MSD, Roche, Novartis, Pierre Fabre, Amgen, Incyte, Abbvie. B.S. and C.C. have a patent US10144772B2 issued, a patent WO2015173259A1 pending, a patent EP3142685B1 issued, a patent ES2748380T3 issued. B.S., C.C. and N.M. have a patent EP3407911A1 pending, a patent JP2019503384A pending, a patent US20190038763A1 pending, and a patent WO2017129790A1 pending. The other authors declare no competing interests.

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Montfort, A., Virazels, M., Colacios, C. et al. Combining TNF blockade with immune checkpoint inhibitors in patients with cancer. Nat Rev Rheumatol 17, 577 (2021). https://doi.org/10.1038/s41584-021-00653-8

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