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The diagnostic work-up of cancer-associated myositis

Selva-O’Callaghan, Alberta; Martinez-Gómez, Xavierb; Trallero-Araguás, Ernestoc; Pinal-Fernández, Iagod

Current Opinion in Rheumatology: November 2018 - Volume 30 - Issue 6 - p 630–636
doi: 10.1097/BOR.0000000000000535
MYOSITIS AND MYOPATHIES: Edited by Andrea Doria and Anna Ghirardello
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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.

aSystemic Autoimmune Diseases Unit, Medicine Department

bPreventive Medicine and Epidemiology, Vall d’Hebron General Hospital, Universitat Autònoma de Barcelona

cRheumatology Unit, Vall d’Hebron General Hospital, Barcelona, Spain

dMuscle Diseases Unit, NIAMS, National Institutes of Health, Bethesda, Maryland, USA

Correspondence to Albert Selva-O’Callaghan, MD, PhD, Systemic Autoimmune Diseases Unit, Medicine Department, Vall d’Hebron General Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain. E-mail: aselva@vhebron.net

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