AS cancer therapies evolve and autoimmune diseases become more prevalent, the intersection of oncology and rheumatology, onco-rheumatology, is emerging as a critical field demanding transdisciplinary care. A new study highlights the increasing complexity of managing patients living with both malignancies and rheumatic conditions, underscoring the urgent need for cohesive, collaborative treatment models.
Traditional “single-disease” approaches are proving inadequate in this space, where immunotherapies can provoke immune-related adverse events (irAEs), including rheumatic manifestations. Rheumatic irAEs (Rh-irAEs), affecting 5–10% of patients treated with immune checkpoint inhibitors (ICIs), remain underrecognized. Their diagnosis is often obscured by vague symptoms, lack of consistent biomarkers, or attribution to underlying cancer. Yet, in severe cases such as myositis or myocarditis, Rh-irAEs may carry mortality rates as high as 22%.
Despite this, no standardized diagnostic protocols or screening guidelines currently exist. The article highlights significant data gaps, such as the lack of clarity on how autoimmune diseases and their treatments influence cancer risk and outcomes. For example, methotrexate and biologic DMARDs are not consistently associated with higher malignancy rates, while recent concerns about Janus kinase (JAK) inhibitors have prompted global safety alerts—though evidence remains mixed.
Adding urgency, both cancer and autoimmune conditions are on the rise. By 2050, rheumatoid arthritis cases are expected to increase by 80%, mirroring global cancer projections. Shared risk factors—smoking, infections, and pollution, drive both disease groups, reinforcing the call for integrated prevention and management strategies.
To address these complexities, the newly formed Group of Multidimensional Onco-RhEumatology (G-MORE) has taken shape. Initiated by the Onco-Rheumatology Study Group of the Italian College of Rheumatology, G-MORE aims to foster evidence-based guidelines, cross-specialty dialogue, and long-term patient-centred solutions.
This movement toward transdisciplinarity may be the only path forward. With more patients living longer and navigating multiple chronic conditions, it is no longer enough to treat diseases in silos. The future of onco-rheumatology lies in sustained, integrated care, delivered by teams who understand the full scope of the patient journey.
Reference:
Marotto D et al. Onco-rheumatology: from rags to riches, a transdisciplinary evolution. Rheumatology Advances in Practice. 2025;9(2):rkaf053.
