Autoantibodies as biomarkers of cancer risk in dermatomyositis

Dermatomyositis (DM) is a cardinal example of an autoimmune rheumatic disease associated with an increased risk of cancer. Research over the past 2 decades highlights that specific DM autoantibodies are associated with overall risk of cancer emergence, with recent research identifying co-occurring "add-on" autoantibodies that appear to attenuate malignancy risk. Although the mechanism of this association remains unclear, a leading hypothesis is cancer-induced autoimmunity in which physiologic cancer immunosurveillance leads to autoimmune disease in the appropriate host. This review synthesizes our current understanding of autoantibodies and DM-associated malignancy with a focus on helping to individualize cancer risk stratification and allow selection of the appropriate aggressive and timely cancer screening modality.