Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline

Journal of Clinical Oncology, Journal Year: 2018, Volume and Issue: 36(17), P. 1714 - 1768

Published: Feb. 14, 2018

Purpose To increase awareness, outline strategies, and offer guidance on the recommended management of immune-related adverse events in patients treated with immune checkpoint inhibitor (ICPi) therapy. Methods A multidisciplinary, multi-organizational panel experts medical oncology, dermatology, gastroenterology, rheumatology, pulmonology, endocrinology, urology, neurology, hematology, emergency medicine, nursing, trialist, advocacy was convened to develop clinical practice guideline. Guideline development involved a systematic review literature an informal consensus process. The focused guidelines, reviews meta-analyses, randomized controlled trials, case series published from 2000 through 2017. Results identified 204 eligible publications. Much evidence consisted observational data, series, reports. Due paucity high-quality events, recommendations are based expert consensus. Recommendations for specific organ system-based toxicity diagnosis presented. While varies according system affected, general, ICPi therapy should be continued close monitoring grade 1 toxicities, exception some neurologic, hematologic, cardiac toxicities. may suspended most 2 consideration resuming when symptoms revert or less. Corticosteroids administered. Grade 3 toxicities generally warrant suspension ICPis initiation high-dose corticosteroids (prednisone mg/kg/d methylprednisolone mg/kg/d). tapered over course at least 4 6 weeks. Some refractory cases require infliximab other immunosuppressive In permanent discontinuation is endocrinopathies that have been by hormone replacement. Additional information available www.asco.org/supportive-care-guidelines www.asco.org/guidelineswiki .

Language: Английский

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Adverse effects of immune-checkpoint inhibitors: epidemiology, management and surveillance

Nature Reviews Clinical Oncology, Journal Year: 2019, Volume and Issue: 16(9), P. 563 - 580

Published: May 15, 2019

Language: Английский

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Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group

Journal for ImmunoTherapy of Cancer, Journal Year: 2017, Volume and Issue: 5(1)

Published: Nov. 21, 2017

Cancer immunotherapy has transformed the treatment of cancer. However, increasing use immune-based therapies, including widely used class agents known as immune checkpoint inhibitors, exposed a discrete group immune-related adverse events (irAEs). Many these are driven by same immunologic mechanisms responsible for drugs' therapeutic effects, namely blockade inhibitory that suppress system and protect body tissues from an unconstrained acute or chronic response. Skin, gut, endocrine, lung musculoskeletal irAEs relatively common, whereas cardiovascular, hematologic, renal, neurologic ophthalmologic occur much less frequently. The majority mild to moderate in severity; however, serious occasionally life-threatening reported literature, treatment-related deaths up 2% patients, varying ICI. Immunotherapy-related typically have delayed onset prolonged duration compared chemotherapy, effective management depends on early recognition prompt intervention with suppression and/or immunomodulatory strategies. There is urgent need multidisciplinary guidance reflecting broad-based perspectives how recognize, report manage organ-specific toxicities until evidence-based data available inform clinical decision-making. Society Immunotherapy (SITC) established Toxicity Management Working Group, which met full-day workshop develop recommendations standardize irAEs. Here we present their consensus managing associated inhibitor therapy.

Language: Английский

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A review of cancer immunotherapy toxicity

CA A Cancer Journal for Clinicians, Journal Year: 2020, Volume and Issue: 70(2), P. 86 - 104

Published: Jan. 16, 2020

Abstract Cancer immunotherapies, including checkpoint inhibitors and adoptive cell therapy, manipulate the immune system to recognize attack cancer cells. These therapies have potential induce durable responses in multiple solid hematologic malignancies thus transformed treatment algorithms for numerous tumor types. immunotherapies lead unique toxicity profiles distinct from toxicities of other therapies, depending on their mechanism action. often require specific management, which can include steroids immune‐modulating therapy consensus guidelines been published. This review will focus chimeric antigen receptor T cells, pathophysiology, diagnosis, management.

Language: Английский

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Innate Immune Landscape in Early Lung Adenocarcinoma by Paired Single-Cell Analyses

Cell, Journal Year: 2017, Volume and Issue: 169(4), P. 750 - 765.e17

Published: May 1, 2017

Language: Английский

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Immune-related adverse events of checkpoint inhibitors

Nature Reviews Disease Primers, Journal Year: 2020, Volume and Issue: 6(1)

Published: May 7, 2020

Language: Английский

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Previous radiotherapy and the clinical activity and toxicity of pembrolizumab in the treatment of non-small-cell lung cancer: a secondary analysis of the KEYNOTE-001 phase 1 trial

The Lancet Oncology, Journal Year: 2017, Volume and Issue: 18(7), P. 895 - 903

Published: May 25, 2017

Language: Английский

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Tumour- and class-specific patterns of immune-related adverse events of immune checkpoint inhibitors: a systematic review

Annals of Oncology, Journal Year: 2017, Volume and Issue: 28(10), P. 2377 - 2385

Published: June 1, 2017

Language: Английский

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Treatment-Related Adverse Events of PD-1 and PD-L1 Inhibitors in Clinical Trials

JAMA Oncology, Journal Year: 2019, Volume and Issue: 5(7), P. 1008 - 1008

Published: April 25, 2019

Programmed cell death (PD-1) and programmed ligand 1 (PD-L1) inhibitors have been increasingly used in cancer therapy. Understanding the treatment-related adverse events of these drugs is critical for clinical practice.To evaluate incidences PD-1 PD-L1 differences between different types.PubMed, Web Science, Embase, Scopus were searched from October 1, 2017, through December 15, 2018.Published trials on single-agent with tabulated data included.Trial name, phase, type, inhibitor used, dose escalation, dosing schedule, number patients, all events, criteria event reporting extracted each included study, bayesian multilevel regression models applied analysis.Incidences types.This systematic review meta-analysis 125 involving 20 128 patients; 12 277 (66.0%) 18 610 patients 106 studies developed at least any grade (severity), 2627 (14.0%) 715 110 3 or higher severity. The most common all-grade fatigue (18.26%; 95% CI, 16.49%-20.11%), pruritus (10.61%; 9.46%-11.83%), diarrhea (9.47%; 8.43%-10.58%). (0.89%; 0.69%-1.14%), anemia (0.78%; 0.59%-1.02%), aspartate aminotransferase increase (0.75%; 0.56%-0.99%). Hypothyroidism (6.07%; 5.35%-6.85%) hyperthyroidism (2.82%; 2.40%-3.29%) frequent endocrine immune-related events. Nivolumab was associated mean compared pembrolizumab (odds ratio [OR], 1.28; 0.97-1.79) (OR, 1.30; 0.89-2.00). a incidence 1.58; 1.00-2.54).Different appear to varying events; comprehensive summary provides an important guide clinicians.

Language: Английский

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Management of toxicities from immunotherapy: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up

Annals of Oncology, Journal Year: 2022, Volume and Issue: 33(12), P. 1217 - 1238

Published: Oct. 18, 2022

Language: Английский

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