Immunotherapy in metastatic melanoma: a novel scenario of new toxicities and their management

Melanoma Management

Antonio M Grimaldi¹  Vito Vanella¹  Paolo A Ascierto¹  Claudia Trojaniello¹  Ester Simeone²  Maria G Vitale²  Marco Palla²  Lucia Festino² 

[1] Innovative Therapies Unit – Istituto Nazionale Tumori Fondazione ‘G. Pascale,’ IRCCS, 80131, Napoli, Italy;;1Unit of Melanoma, Cancer Immunotherapy &

关键词: anti-CTLA-4;    anti-PD1;    checkpoint inhibitors;    combination therapy;    immune-related adverse events;   

DOI  :  10.2217/mmt-2019-0005

来源: DOAJ

【 摘 要 】

Checkpoint inhibitors can cause an imbalance in immune tolerance that may clinically manifest as immune-related adverse events (irAEs). These events may involve many organs and tissues, including the skin, gastrointestinal (GI) tract, liver, endocrine system, kidneys, central nervous system (CNS), eyes and lungs. The incidence of irAEs appears to be lower with anti-programmed death antigen-1/programmed death antigen-ligand-1 agents than with the anti-cytotoxic T-lymphocyte-associated protein-4 antibody ipilimumab. Combined immunotherapy does not appear to be associated with novel safety signals compared with monotherapy, but more organs may be involved. Increased experience and the use of algorithms for the most common irAEs have resulted in severe toxicity and related deaths being reduced. However, continuous vigilance, especially regarding less common events, is needed to better characterize the wide spectrum of clinical manifestations.

【 授权许可】

Unknown