Immune-related Adverse Events from Immune Checkpoint Inhibitor Therapy
Publication Date: November 1, 2021
Key Points
Key Points
- Immunotherapy has revolutionized the treatment of many different types of cancers.
- Immune checkpoint inhibitors (ICPi) targeting cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4), programmed cell death-1 (PD-1), and PD ligand 1 (PD-L1) work by preventing the receptors and ligands from binding to each other, thereby disrupting signaling so that T-cells can recognize and attack cancer cells. They are currently the standard of care in the treatment of several cancers, including a variety of solid-organ and hematological malignancies.
- The use of ICPis is rising exponentially, with approximately 40% of patients with cancer in the United States in 2019 eligible for treatment with ICPis.
- Immune checkpoint blockade therapy is associated with a spectrum of side effects that is quite different from other systemic therapies such as cytotoxic chemotherapy.
- Moderate to severe immune-related adverse events (irAEs) may be associated with life-threatening declines in organ function and quality of life, and fatal outcomes have been reported.
Key Recommendations
...Key Recommendatio...
...e following are general recommendations that sho...
...mmended that clinicians manage toxici...
...endations in this guideline are consensus bas...
Treatment
...Treatment...
Table A2: Immunosuppressive Agents...
...only Conducted Testing at Baseline...
...A4. Commonly Conducted Testing During irAE Man...
...aneous Toxicities 1.1 R...
...ble 2. Gastrointestinal (GI) Toxicities...
...Lung Toxicities 3.1 Pneumoniti...
...docrine Toxicities 4.1 Thyroid...
...usculoskeletal Toxicities...
...6. Renal Toxicities Neph...
...System Toxicities 7.1 Myasthen...
.... Hematologic Toxicities 8.1 Hemolyt...
...Cardiovascular Toxicities...
.... Ocular Toxicities Evaluat...