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Managing adverse effects of immunotherapy
James N Gerson1, Chethan Ramamurthy1, Hossein Borghaei1
1Fox Chase Cancer Center, Temple University Health System, Philadelphia, Pennsylvania.
Clinical Advances in Hematology & Oncology : H&O
|June 1, 2018
Summary
Immune checkpoint inhibitors like ipilimumab, nivolumab, and pembrolizumab show great cancer treatment efficacy. However, these therapies can cause unique immune-related adverse events (irAEs) that require prompt medical attention.
Area of Science:
- Oncology
- Immunology
- Pharmacology
Background:
- Immune checkpoint inhibitors (ICIs) targeting CTLA-4, PD-1, and PD-L1 have revolutionized cancer treatment.
- Approved ICIs include ipilimumab, nivolumab, pembrolizumab, atezolizumab, avelumab, and durvalumab for advanced malignancies.
- These therapies represent a significant shift from traditional chemotherapy and targeted treatments.
Purpose of the Study:
- To highlight the efficacy of immune checkpoint inhibitors in cancer therapy.
- To describe the unique immune-related adverse events (irAEs) associated with these agents.
- To emphasize the critical need for oncologists to recognize and manage irAEs.
Main Methods:
- Review of approved immune checkpoint inhibitors and their clinical applications.
- Characterization of immune-related adverse events (irAEs) based on clinical presentation.
- Discussion of the management principles for irAEs in oncology.
Main Results:
- Significant efficacy observed across various cancer types with ICI therapy.
- irAEs can manifest as diverse autoimmune phenomena affecting any organ system.
- While rare, irAEs can be severe and life-threatening.
Conclusions:
- Immune checkpoint inhibitors offer remarkable efficacy in treating advanced cancers.
- Effective management of irAEs is crucial for patient safety and treatment continuation.
- Oncologists must be vigilant in identifying and treating immune-related adverse events.
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