Novel Cellular and Immunotherapy: Toxicities and Perioperative Implications

Area of Science:

• Oncology
• Immunology
• Anesthesiology

Background:

• Targeted cellular and immunotherapies represent a paradigm shift in cancer treatment, differing from traditional chemotherapy.
• These novel agents leverage the immune system to destroy cancer cells and overcome tumor immune evasion.
• Their unique mechanisms can lead to distinct acute and chronic toxicities affecting various organ systems.

Purpose of the Study:

• To inform perioperative providers about the mechanisms of novel cancer immunotherapies.
• To highlight the acute and subacute toxicity profiles of these emerging treatments.
• To emphasize the importance of updated knowledge for managing cancer patients in the perioperative setting.

Main Methods:

• Review of current literature on targeted cellular and immunotherapies.
• Analysis of known toxicity profiles and their clinical manifestations.
• Discussion of implications for perioperative management.

Main Results:

• Immunotherapies augment T-cell recognition and target tumor antigens.
• Toxicities include enteritis, pneumonitis, hypophysitis, and hepatitis, which can mimic other conditions.
• These toxicities significantly impact perioperative morbidity and require specific management considerations.

Conclusions:

• Perioperative providers must be knowledgeable about immunotherapy mechanisms and toxicities.
• Awareness of immunotherapy-related toxicities is essential for optimizing perioperative care and patient outcomes.
• Proactive management, including screening and prophylaxis, is necessary for patients receiving immunotherapy.