Managing cancer in patients with concomitant rheumatoid arthritis poses special challenges that require close coordination of care between oncologists and rheumatologists. Immune-related adverse events with use of checkpoint inhibitors for immunotherapy of cancer. Potential clinical issues needing special consideration include: 1) perioperative management in patients undergoing cancer surgery, which often requires discontinuation of antirrheumatic therapy; 2) use of immunosuppressant therapies for rheumatoid arthritis, especially biologic agents that inhibit cytokine and immune pathways, which conceivably could affect immune-mediated antitumor responses (the issues are different in patients with active cancer vs those with a past history of cancer and no recurrences); 3) management in the palliative care setting; and 4) use of cancer immunotherapy, such as checkpoint inhibitor agents, in patients with pre-existing rheumatoid arthritis. Hydroxychloroquine with histoplasmosis Pharmacological classification of hydroxychloroquine Preclinical studies indicate autophagy inhibition with hydroxychloroquine HCQ can augment the efficacy of DNA-damaging therapy. The primary objective of this trial was to determine the maximum tolerated dose MTD and efficacy of HCQ in combination with radiation therapy RT and temozolomide TMZ for newly diagnosed glioblastoma GB. The average number of adjuvant treatment cycles of concurrent TMZ and HCQ was 5.1. Ninety patients 98% were off treatment, 66% due to disease progression or death, 3% due to toxicity, 12% due to treatment delay of more than 14 d, 9% due to patient refusal of further treatment, or 3 due to investigator withdrawal for noncompliance. Patients receive hydroxychloroquine orally PO twice daily BID for 2 weeks, then undergo standard of care stereotactic body radiation therapy SBRT or metastasectomy. Patients then receive hydroxychloroquine PO BID beginning post-operative day 1 for 3 months in the absence of disease progression or unacceptable toxicity. In all cases, clinical decision making must include a careful weighing of risks and benefits of both cancer treatments and antirrheumatic therapies, with attention given to prognosis and life expectancy, quality of life, and patient preferences. TNF inhibitor therapy and risk of breast cancer recurrence in patients with rheumatoid arthritis: a nationwide cohort study. We explore these clinical issues in case-based scenarios. Plaquenil and radiation therapy toxiciy Mixed connective tissue disease and radiation toxicity - Mayr., A phase I/II trial of hydroxychloroquine in conjunction with radiation. Allergy signs to hydroxychloroquineChloroquine resistant malaria treatment slideshareChloroquine effective against malaria Therapy with hydroxychloroquine, 200 mg daily, and prednisone, 6 mg daily, was continued during RT. The predilection for early radiation toxicity in patients with LE may be related to the basal cell layer of the epidermis, because this common target structure is affected by both the radiation injury and the autoimmune process. Mixed connective tissue disease and radiation toxicity.. Hydroxychloroquine for the Treatment of Recurrent, Oligometastatic.. Severe radiation therapy-related soft tissue toxicity in a.. Hydroxychloroquine. As a treatment for sarcoidosis, the antimalarial drug hydroxychloroquine Plaquenil® is most likely to be effective in patients with dermatologic involve-ment, joint manifestations and hypercalcemia. Due to poten-tial macular toxicity, it is recommended that patients on hydroxychloroquine have an eye examination every 6-12. Note This document contains side effect information about hydroxychloroquine. Some of the dosage forms listed on this page may not apply to the brand name Plaquenil. For the Consumer. Applies to hydroxychloroquine oral tablet. Along with its needed effects, hydroxychloroquine the active ingredient contained in Plaquenil may cause some unwanted effects. Introduction. The extent to which patients with pre-existing connective tissue diseases such as rheumatoid arthritis, discoid or systemic lupus erythematosus SLE, polymyositis, dermatomyositis, and scleroderma and mixed connective tissue diseases are at increased risk of radiotherapy toxicity has been controversial.