Immunotherapy toxicity. Diagnosis and treatment

Area of Science:

• Oncology
• Immunology
• Pharmacology

Background:

• Immune checkpoint inhibitors (ICIs) targeting CTLA-4, PD-L1, and PD-1 have transformed cancer therapy by enhancing anti-tumor immunity.
• While effective, ICIs can induce unique immune-related adverse events (irAEs) affecting various organ systems.
• Understanding and managing irAEs is crucial for optimizing ICI treatment outcomes.

Purpose of the Study:

• To provide a comprehensive review of current knowledge on irAEs associated with ICI therapy.
• To serve as a clinical resource for healthcare professionals managing patients on ICIs.
• To consolidate information on irAE grading, incidence, diagnosis, and management.

Main Methods:

• A systematic literature search was conducted in the Medline database.
• The search included original and review articles published up to June 2020.
• Keywords used were 'immune checkpoint inhibitor toxicities' and 'immune related adverse event'.

Main Results:

• The review synthesizes data on the spectrum of irAEs encountered with ICI treatments.
• It details established grading criteria, typical incidence rates, diagnostic approaches, and current management strategies for irAEs.
• The information presented aims to guide clinical decision-making in ICI-related toxicity.

Conclusions:

• Further research is needed to balance the benefits of combination ICI therapy against increased risks.
• Identifying specific patient subgroups who benefit most from ICIs is essential.
• Optimizing the management of irAEs will improve the therapeutic index of ICI treatments.