Challenging Cases: Management of Immune-Related Toxicity

The approvals of six checkpoint inhibitory antibodies since 2011 have established immunotherapy for cancer as a fifth treatment modality after chemotherapy, surgery, radiation, and targeted therapy. Long-lasting responses have been observed in melanoma, non-small cell lung cancer, renal cell cancer, and head and neck cancer, to name a few, and more approvals for these drugs undoubtedly are coming in the near future. The application of checkpoint inhibitors has expanded well beyond melanoma, and, with wider use, the management of the immune-related adverse events (irAEs) that accompany these drugs has received increased attention. In this work, several patient cases are presented that highlight how to optimally manage these unique toxicities and that illustrate the basic principles of care for patients who receive checkpoint inhibition.