New Canadian Guidelines Help Clinicians Balance Cancer Treatment and Rheumatic Disease Care

Vancouver (February 3, 2026) – Immune checkpoint inhibitors (ICI) therapies are transforming cancer treatment, offering new hope to many patients. But for people living with systemic autoimmune rheumatic diseases (including inflammatory arthritis), these treatments can be complicated.

While these medications are very effective at treating cancer by turning on the immune system against cancer cells, they can cause or worsen pre-existing autoimmune rheumatic diseases. Also, medications used to treat pre-existing arthritis by suppressing the immune system can make cancer treatment with ICI less effective.

Clinicians have had limited, non–disease-specific guidance on how to manage this delicate balance, as patients with rheumatic diseases were often excluded from cancer studies. Now there are new clinical guidelines from the Canadian Research Group of Rheumatology in Immuno-Oncology (CanRIO) and the Canadian Rheumatology Association (CRA) that aim to change that.

Several Arthritis Research Canada team members contributed to these guidelines, including Dr. Carrie Ye, Dr. Shahin Jamal, Dr. Marie Hudson, Dr.  May Choi,   Dr. Inés Colmegna, Dr. Janet Roberts, Dr. Sabrina Hoa, Dr. Glen Hazlewood, and Lourdes Gonzalez Arreola.

“With thoughtful, coordinated care, it’s possible to treat cancer while still managing autoimmune rheumatic diseases safely,” said Dr. Shahin Jamal.

What The Research Team Did

CanRIO and the CRA formed a multidisciplinary panel that reviewed 67 relevant studies and built recommendations through consensus with rheumatologists, oncologists, researchers, and a patient partner.

Two guideline papers were published in the Journal of Rheumatology. The guidelines help clinicians manage existing immunosuppressive medications in people with rheumatic disease who are starting ICI therapy for cancer treatment. Importantly, these are “living guidelines,” meaning they will be updated as new evidence emerges.

Why This Research Matters

The guidelines emphasize shared decision-making and coordinated care across specialties.

Clinicians are encouraged to do the following:

1. To not exclude patients with autoimmune rheumatic diseases from ICI therapy
2. To balance the risks of rheumatic disease flares and possible reduction in ICI efficacy with immunosuppressive medications
3. To include the entire team in shared decision-making (e.g. oncologists, rheumatologists, other specialists, and the patient)
4. To tailor decisions to disease activity, treatment intent, and the patient’s values.

Rather than a one-size-fits-all approach, these guidelines provide tailored recommendations for specific inflammatory arthritis and systemic autoimmune rheumatic diseases. These guidelines also provide clearer direction for clinicians and reassurance for patients, supporting equitable access to cancer treatment while protecting those who also live with rheumatic diseases.

Read part 1 and part 2 of these papers on The Journal of Rheumatology website.

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ABOUT ARTHRITIS RESEARCH CANADA:

Arthritis Research Canada is the largest clinical arthritis research institution in North America. Our mission is to transform the lives of people impacted by arthritis through patient-centred research and engagement. Arthritis Research Canada is home to a team of over 100 researchers, trainees and staff whose life-changing research is creating a future where people with arthritis have the knowledge and tools to triumph over pain and disability. Arthritis Research Canada is conducting research from coast to coast with centres in British Columbia, Alberta, Ontario, Quebec, and Nova Scotia and scientists affiliated with 10 major Canadian universities.

For more information or to arrange an interview, please contact:

Bernice Rahman
Marketing and Communications Officer
Arthritis Research Canada
brahman@arthritisresearch.ca