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Identifying and managing the adverse effects of immune checkpoint blockade

Arthur Winer1, J Nicholas Bodor1, Hossein Borghaei1

  • 1Fox Chase Cancer Center, Philadelphia, PA, USA.

Journal of Thoracic Disease
|March 30, 2018
PubMed

Insights

Cancer immunotherapy using immune checkpoint inhibitors (cytotoxic T-lymphocyte-associated protein [CTLA-4] and programmed death-1 [PD-1]) improves survival but can cause immune-related adverse events (irAEs). This review details recognizing and managing these toxicities.

Area of Science:

  • Oncology
  • Immunology
  • Pharmacology

Background:

  • Cancer immunotherapy has revolutionized oncology treatment.
  • Immune checkpoint inhibitors targeting CTLA-4 and PD-1 pathways improve survival in various advanced cancers.
  • The number of approved immunotherapy drugs is growing.

Purpose of the Study:

  • To review the emergence and management of immune-related adverse events (irAEs) associated with cancer immunotherapy.
  • To provide an approach for prompt recognition and management of irAEs.
  • To minimize patient morbidity and mortality from irAEs.

Main Methods:

  • Literature review of immunotherapy and immune-related adverse events.
  • Analysis of clinical trial data regarding irAEs.
  • Synthesis of current management strategies for irAEs.

Main Results:

  • Immunotherapy targeting CTLA-4 and PD-1 pathways demonstrates efficacy in multiple advanced cancers.
  • Immune-related adverse events (irAEs) are a significant class of side effects due to immune system overactivation.
  • irAEs can affect virtually any organ system and may be life-threatening.

Conclusions:

  • Prompt recognition and management of irAEs are crucial for patient safety.
  • Effective irAE management can mitigate treatment-related morbidity and mortality.
  • Further research and clinical guidelines are needed to optimize irAE care.
Keywords:
Checkpoint inhibitorsimmunotherapytoxicities

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