Multidisciplinary collaboration is crucial for rheumatologist Laura Cappelli. Her recent study, conducted with Johns Hopkins oncologists, showed that patients with both an rheumatic disease and lung cancer who were diagnosed earlier had better survival outcomes compared to patients without such rheumatic conditions. Cappelli discussed her research in advance of a presentation at the American College of Rheumatology / Association of Rheumatology Professionals 2022 annual conference.
Hi, my name is Laura Capelli and I'm a rheumatologist at johns Hopkins. Today, I'd love to talk to you about one of our new studies where we collaborated with oncology to understand outcomes of cancer and patients with and without Immune disease. We took advantage of a great resource at Johns Hopkins, the institutional cancer registry to identify over 10,000 patients with lung cancer who had been treated at Johns Hopkins over the past decade or so. And from there we then identified which of those patients had autoimmune rheumatic diseases. And these are diseases that we, as rheumatologists take care of every day, like rheumatoid arthritis, scleroderma, lupus psoriatic arthritis. So we then had two groups of patients, one who had autoimmune rheumatic disease and cancer and one who did not. And we were able to compare several things between those two groups. First, we wanted to understand if there were differences between the size of the cancer and the stage of the cancer at diagnosis with the two groups of patients. And we found that patients with autoimmune rheumatic disease actually had earlier stage cancer at diagnosis than those patients who did not have autoimmune disease. And this was very important for several reasons. One we know that early stage cancer has better outcomes and diagnosing cancer early is a goal of many cancer screening programs that we do throughout the country. We also know that treatment is very different as when cancer is diagnosed early than when cancer is diagnosed later. So it was very interesting to learn that our patients with autoimmune rheumatic disease actually had earlier stage cancer at diagnosis. Next, we wanted to focus on cancer outcomes and survival from cancer, which is really, you know, the most important outcome for patients. And so we compared the overall survival in patients with and without autoimmune disease with lung cancer and we took into account things that might change that survival, you know, such as the stage and size of the um er and the age of the patient at diagnosis, and even when we controlled for those things that might make outcomes differ. We found that patients with autoimmune disease had better survival outcomes than those without autoimmune disease. When we looked at these lung cancer outcomes. And so this was also a very interesting finding and I think could have two possible explanations. First are patients who have autoimmune rheumatic disease are engaged in health care and they might be more carefully monitored and they might be more likely to engage in healthcare at an earlier place. Another possible explanation for this finding is that the patients with autoimmune rheumatic disease with having a more active immune system were able to mount a better immune response against their tumors, leading to better outcomes. And certainly future studies to investigate this further and to look at the same sort of outcomes in patients with other types of cancer will help us learn more about the relationship between autoimmune disease and cancer. And so we look forward to future collaborations with oncology to do this