Immune-related adverse events of immune checkpoint inhibitors: a brief review

Current oncology

G. Myers¹ 

[1]Horizon Health Network–The Moncton Hospital

[2]Canadian Association of Pharmacy in Oncology

关键词: Immune-related adverse events;    immune checkpoint inhibitors;    toxicity;    corticosteroids;    immunosuppression;   

DOI  :  10.3747/co.25.4235

学科分类：肿瘤学

来源: Multimed, Inc.

【 摘 要 】

Immune checkpoint inhibitors ( ici s) such as inhibitors of  ctla -4, PD-1, and PD-L1, given as monotherapy or combination therapy have emerged as effective treatment options for immune-sensitive solid tumours and hematologic malignancies. The benefits of  ici s can be offset by immune-related adverse events (ir ae s) that leave all organ systems vulnerable and subsequently increase the risk for morbidity and mortality.Because of fluctuating onset and prolonged duration, the toxicities associated with ir ae s represent a shift from the understanding of conventional anticancer toxicities. The  ctla -4 and PD-1/PD-L1 inhibitors modulate T-cell response differently, resulting in distinct toxicity patterns, toxicity kinetics, and dose–toxicity relationships. Using individualized patient education, screening, and assessment for the early identification of ir ae s is key to proactive management and is therefore key to improving outcomes and prolonging therapy.Management of ir ae s is guided by appropriate grading, which sets the stage for the treatment setting (outpatient vs. inpatient),  ici  treatment course (delay vs. discontinuation), supportive care, corticosteroid use, organ specialist consultation, and additional immunosuppression. Health care professionals in oncology must work collaboratively with emergency and community colleagues to facilitate an understanding of ir ae s in an effort to optimize seamless care.

【 授权许可】

Unknown