Toxicity of Immunotherapeutic Agents
Cristina Gutierrez1, Colleen McEvoy2, Daniel Reynolds3
1Department of Critical Care, Division of Anesthesiology and Critical Care, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard. Houston, TX 77030, USA.
Critical Care Clinics
|May 31, 2021
Summary
Severe toxicities from cancer immunotherapies like CAR T-cells and checkpoint inhibitors are increasing. Intensive care units must be aware of these critical illnesses and adopt a multidisciplinary approach for management.
Area of Science:
- Oncology
- Immunology
- Critical Care Medicine
Background:
- Increasing cancer incidence and widespread immunotherapy use lead to more severe treatment toxicities.
- Chimeric antigen receptor T-cells, monoclonal antibodies, and immune checkpoint inhibitors are common immunotherapies causing critical illness.
- Intensive care unit (ICU) teams require heightened awareness of these adverse events.
Purpose of the Study:
- To review common severe toxicities associated with cancer immunotherapy.
- To provide a therapy-specific and system-based management approach for critically ill patients.
- To emphasize the importance of multidisciplinary care for immunotherapy-related toxicities.
Main Methods:
- Review of common severe toxicities from chimeric antigen receptor T-cells, monoclonal antibodies, and immune checkpoint inhibitors.
- Analysis of critical illness presentations in cancer patients undergoing immunotherapy.
- Synthesis of current recommendations for diagnosis and treatment.
Main Results:
- Immunotherapy-induced toxicities represent a growing challenge in critical care.
- Specific toxicities vary based on the type of immunotherapy used.
- A structured, multidisciplinary approach is crucial for effective patient management.
Conclusions:
- Early recognition and management of immunotherapy toxicities are vital for improving outcomes.
- A coordinated, system-based approach involving various specialists is recommended.
- Continued education for ICU teams on immunotherapy complications is essential.
Keywords:
Chimeric antigen receptor T-cellsImmune checkpoint inhibitorsImmunotherapyIntensive care unitMonoclonal antibodiesToxicitiesMore Related Videos
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