PD-1/PD-L1 Inhibitor - Related Adverse Events and Their Management in Breast Cancer

Area of Science:

• Oncology
• Immunotherapy
• Drug Development

Background:

• Programmed cell death 1 (PD-1) and PD-L1 inhibitors are increasingly used in breast cancer treatment.
• Combination therapies involving PD-1/PD-L1 inhibitors with chemotherapy, targeted agents, and radiation are common.
• Managing immune-related adverse effects (irAEs) alongside treatment efficacy presents a significant clinical challenge.

Purpose of the Study:

• To review the incidence of irAEs in breast cancer patients receiving PD-1/PD-L1 inhibitors combined with other treatments.
• To systematically summarize the clinical management strategies for organ-specific irAEs.
• To highlight the critical need for effective irAE management in combined immunotherapy regimens.

Main Methods:

• Literature review of clinical trials and studies on PD-1/PD-L1 inhibitor combinations in breast cancer.
• Analysis of reported incidences of irAEs across different treatment combinations.
• Systematic summary of management guidelines for various irAEs.

Main Results:

• PD-1/PD-L1 inhibitors combined with chemotherapy, CTLA-4 inhibitors, targeted therapy, and radiotherapy can cause various irAEs.
• Specific management strategies for neurological, hematologic, and cardiac toxicities are discussed.
• Discontinuation of immunotherapy may be necessary for severe irAEs.

Conclusions:

• Effective management of irAEs is essential for maintaining the balance between treatment efficacy and patient safety in combined immunotherapy for breast cancer.
• There is an urgent need for improved strategies to manage irAEs.
• Clinicians must enhance their awareness and preparedness for managing adverse immune reactions.