Long-term immune related adverse events DOI
Léo Plaçais, Olivier Lambotte

Current Opinion in Oncology, Год журнала: 2024, Номер unknown

Опубликована: Дек. 17, 2024

Purpose of review Long-term immune related adverse events (irAEs) are an increasing reality in cancer patients treated with checkpoint inhibitors (ICIs) but remain under-reported. With the number ICI increasing, we here aimed to expose current evidence on their clinical presentations and diagnosis criteria. Recent findings First described validation trials, long term irAEs were further characterized through retrospective studies, providing clues frequency, spectrum, risk factors impact patient's quality life. recommendations proposed consensual definitions delineate different subtypes, from delayed/late-onset irAE chronic active inactive irAE, paving way future prospective studies. Summary Knowledge long-term subtypes presentation is required increase detection diagnosis, better weight therapeutic decisions improve care.

Язык: Английский

Immune‐Mediated Liver Injury From Checkpoint Inhibitor: An Evolving Frontier With Emerging Challenges DOI Creative Commons
Lily Dara,

Eleonora De Martin

Liver International, Год журнала: 2025, Номер 45(2)

Опубликована: Янв. 27, 2025

ABSTRACT Over the past decade, immune checkpoint inhibitors (ICIs) have transformed treatment of cancer, though they come with risk immune‐related adverse (irAEs) events such as hepatotoxicity or Immune‐mediated Liver Injury from Checkpoint Inhibitors (ILICI). ILICI is a serious irAE that, when severe, requires cessation ICI and initiation immunosuppression. Cytotoxic T Lymphocytes (CTLs) play central role in ILICI; however, are just part picture immunotherapy broadly impacts all aspects microenvironment can directly indirectly activate innate adaptive cells. Clinically, our understanding this entity grows, we encounter new challenges. The presentation heterogeneous respect to latency, pattern injury (hepatitis vs. cholangitis) severity. This review focuses on knowledge regarding factors, including refractory steroids. An emerging topic, possibility rechallenge while accepting some risk, patients who experience but require immunotherapy, also discussed. provides an update current knowns unknowns highlights several gaps where studies needed.

Язык: Английский

Процитировано

2
Increased serum NfL and GFAP levels indicate different subtypes of neurologic immune‐related adverse events during treatment with immune checkpoint inhibitors DOI Creative Commons
Cynthia L. Schmitt, K. Müller, Steffen Tiedt

и другие.

International Journal of Cancer, Год журнала: 2025, Номер unknown

Опубликована: Янв. 20, 2025

Abstract Neurologic immune‐related adverse events (nirAEs) represent rare, yet severe side effects associated with immune checkpoint inhibitor (ICI) therapy. Given the absence of established diagnostic biomarkers for nirAEs, we aimed to evaluate utility serum Neurofilament Light Chain (NfL) and Glial Fibrillary Acidic Protein (GFAP). Fifty‐three patients were included at three comprehensive cancer centers, these 20 manifest nirAEs 11 irHypophysitis. Controls without any irAE ( n = 8) other irAEs 14). Using a single‐molecule enzyme‐linked immunosorbent assay (Simoa), levels measured prior to, during after manifestation (n)irAEs in 80 samples. Symptom severity was graded according Common Criteria Adverse Events (CTCAE) version 5.0. Serum NfL significantly higher nirAE group 20) compared irHypophysitis 11; p .0025) controls 22; .0384). Subgroup analysis demonstrated significant elevation peripheral nerves (PNirAE) contrast neuromuscular syndromes (NMirAE) .0260). GFAP highest affecting central nervous system (CNSirAE) PNirAE NMirAE .0064). increased .0069, .0092). Individuals elevated exhibited less favorable outcomes .0199). Measurement may be helpful differentiation broad spectrum serve as an indicator symptom severity. Further investigation is needed their potential prognostic biomarkers.

Язык: Английский

Процитировано

0
Immune Checkpoint Inhibitor-Induced Pancreatic Injury (ICI-PI) in Adult Cancer Patients: A Systematic Review and Meta-Analysis DOI Open Access
Cha Len Lee,

Israt Jahan Riya,

Ifrat Jahan Piya

и другие.

Cancers, Год журнала: 2025, Номер 17(7), С. 1080 - 1080

Опубликована: Март 24, 2025

Background: Immune checkpoint inhibitor-induced pancreatic injury (ICI-PI) is a rare immunotoxicity, with limited data on treatment and long-term outcomes. Methods: PubMed, EMBASE, Cochrane Library were systematically searched for studies reporting ICI-PI in patients solid malignancies. was defined as inflammation post-ICI exposure, diagnosed via radiologic changes or elevated lipase/amylase levels without other underlying causes. The CTCAE grading system used. primary objectives to assess the frequency, severity, serum abnormalities, management, We conducted proportional single-arm meta-analysis random effects model. Results: analysis included 25 retrospective involving 48,704 patients. Tumor types thoracic/head neck (38%), skin (26%), genitourinary/gynecological (18%), gastrointestinal (12%), others (6%). median age ranged from 56 73 years, follow-up 2.5 45.9 months. occurred 3.60% (95% CI: 1.64-6.28%) of patients, grade ≥ 3 toxicity 59.45% 35.32-81.37%). frequency rates 1.99% CTLA4 inhibitors, 5.01% PD(L)1 7.44% combination ICI therapy (p < 0.01). time onset initiation 30 390 days, symptom resolution 55 84 days. Management corticosteroids (30.20%), intravenous fluids (22.82%), hospitalization (30.46%). Chronic complications affected 63.54% 29.03-91.56%), including primarily diabetes mellitus (DM 89.45%; 95% 61.88-100.0%) exocrine insufficiency (EPI 10.55%; 95%: 0.0-38.12%). recurrence 27.2% those resuming therapy. objective response rate 61.7% 55.08-68.17%). Conclusions: ICI-PI, though infrequent, severe predisposes chronic complications, DM EPI.

Язык: Английский

Процитировано

0
Autoimmune-related adverse events induced by immune checkpoint inhibitors DOI
Yini Sun, Ziyang Zhang, Jia Ke

и другие.

Current Opinion in Immunology, Год журнала: 2025, Номер 94, С. 102556 - 102556

Опубликована: Апрель 11, 2025

Язык: Английский

Процитировано

0
Management of refractory checkpoint inhibitor-induced colitis DOI
Anas Zaher, Maria José Albuquerque Santos,

Hassan Elsaygh

и другие.

Expert Opinion on Drug Safety, Год журнала: 2025, Номер unknown

Опубликована: Апрель 19, 2025

This review discusses the epidemiology, pathophysiology, and factors associated with refractory immune-mediated diarrhea colitis (r-IMDC), emphasizing tailored treatment strategies. The current literature on r-IMDC was reviewed using PubMed (2015-2025), focusing clinical trials, meta-analyses, case reports relevant to its management. Effectively managing is crucial for balancing toxicities antitumor response. Available second third-line management options cases must be carefully evaluated. Future perspectives include development of standardized protocols beyond second-line therapies predictive biomarkers enable personalized treatment.

Язык: Английский

Процитировано

0
Extracorporeal photopheresis vs. systemic immunosuppression for immune-related adverse events: Interim analysis of a prospective two-arm study DOI Creative Commons

Claudia Ertl,

T. Ruf,

Linda Hammann

и другие.

European Journal of Cancer, Год журнала: 2024, Номер 212, С. 115049 - 115049

Опубликована: Сен. 27, 2024

Язык: Английский

Процитировано

3
Immune-related toxic epidermal necrolysis affecting trachea mucosal epithelium: a case report and literature review DOI Creative Commons
Mingbo Zhang, Yang Fu,

Yuxiao Song

и другие.

Frontiers in Pharmacology, Год журнала: 2024, Номер 15

Опубликована: Окт. 18, 2024

Background Monoclonal antibodies against programmed cell death protein-1 (PD-1)/programmed death-ligand-1 (PD-L1) have emerged as critical tools in cancer treatment. However, concerns regarding their potential cutaneous and mucosal toxicity, along with severe complications, drawn clinical attention. Further research is warranted to investigate the adverse reactions treatment strategies associated PD-1 monoclonal antibodies. Methods We present a detailed case report of laryngeal patient who developed toxic epidermal necrolysis (TEN) after antibody. analyzed etiology, diagnosis, approaches by integrating manifestations, pathological examinations, literature research. Results After antibody therapy, exhibited systemic rash, bullae, detachment, which subsequently involved tracheal bronchial mucosa, resulting dyspnea. The recovered treatments steroids, macrolides, immunoglobulins, etanercept, repeated removal scabs via bronchoscopy. Literature reviewing suggests association between pathogenesis Steven Johnson’s Syndrome (SJS) Toxic (TEN), possibly due immune dysregulation. Treatment consists immediate discontinuation suspicious drugs, essential supportive corticosteroid administration, addition immunosuppressants and/or immunoglobulins needed. Conclusion mucocutaneous toxicity induced not limited surface skin but also deep layers, potentially leading life-threatening complications. Therefore, when using antibodies, clinicians should closely monitor events apply appropriate soon possible prevent

Язык: Английский

Процитировано

1
Immune checkpoint inhibition of metastatic melanoma: achieving high efficacy in the face of high toxicity DOI Creative Commons
J. B. Justice, Roma Kankaria, Douglas B. Johnson

и другие.

Expert Review of Clinical Pharmacology, Год журнала: 2024, Номер unknown, С. 1 - 11

Опубликована: Ноя. 21, 2024

Introduction Immune checkpoint inhibitors (ICIs) have advanced the treatment of metastatic melanoma by blocking immune system down-regulators enhancing T-cell-mediated anti-tumor responses. However, many ICIs induce immune-related adverse effects (irAEs) that can impact organ systems.

Язык: Английский

Процитировано

1
Extracorporeal photopheresis effective in immune-related capillary leak/polyserositis in splenectomized patient DOI

Claudia Ertl,

Matthias Kroiß, Lars E. French

и другие.

European Journal of Cancer, Год журнала: 2024, Номер 216, С. 115189 - 115189

Опубликована: Дек. 18, 2024

Язык: Английский

Процитировано

0
Hepatotoxicity in Cancer Immunotherapy: Diagnosis, Management, and Future Perspectives DOI Open Access

Alberto Savino,

A. Rossi, S. Fagiuoli

и другие.

Cancers, Год журнала: 2024, Номер 17(1), С. 76 - 76

Опубликована: Дек. 29, 2024

Cancer immunotherapy, particularly immune checkpoint inhibitors, has positively impacted oncological treatments. Despite its effectiveness, immunotherapy is associated with immune-related adverse events (irAEs) that can affect any organ, including the liver. Hepatotoxicity primarily manifests as hepatitis and, less frequently, cholangitis. Several risk factors, such pre-existing autoimmune and liver diseases, type of combination regimens, play a role in hepatotoxicity (irH), although reliable predictive markers or models are still lacking. The severity irH ranges from mild to severe cases, up to, rare instances, acute failure. Management strategies require regular monitoring for early diagnosis interventions, encompassing strict cases permanent suspension forms. Corticosteroids backbone treatment moderate high-grade damage, alone additional immunosuppressive drugs resistant refractory cases. Given relatively low number lack dedicated prospective studies, much uncertainty remains about optimal management irH, especially most This review presents main features focusing on injury patterns mechanisms, provides an overview landscape, standard care latest evidence.

Язык: Английский

Процитировано

0