Toxicities of novel therapies for hematologic malignancies

Expert Rev Hematol. 2020 Mar;13(3):241-257. doi: 10.1080/17474086.2020.1728249. Epub 2020 Feb 17.

Abstract

Introduction: Over the last decade targeted therapies have transformed the treatment landscape for hematologic malignancies with >70 new or extended approvals by the FDA since 2010. Since many of these drugs are registered for multiple entities and >1/3 were approved in the last two years, treatment options in hematology are rapidly expanding. Despite the justified excitement around the often previously unseen emerging therapeutic potential, distinct side-effect profiles require vigilance and adequate management by patients and caregivers.Areas covered: This review provides a summary of the unique toxicity profiles of therapies for hematologic malignancies during the last decade with a focus on clinical implications and applicability. Due to the already wide implementation in common practice or an immense potential thereof selected treatments such as immune checkpoint inhibitors, various monoclonal antibodies, tyrosine kinase inhibitors and CAR T-cell therapies are discussed in detail. Challenges and potential strategies to assess and manage real-world toxicity after drug approval are addressed.Expert opinion: The rapidly expanding therapeutic landscape of hematologic malignancies comes with a broad spectrum of side effects which are distinct from conventional hematotoxicity and require alertness.

Keywords: CAR T-cell therapy; checkpoint inhibition; hematologic malignancies; side effect; targeted therapy; toxicity management.

Publication types

  • Review
  • Video-Audio Media

MeSH terms

  • Antineoplastic Agents, Immunological* / adverse effects
  • Antineoplastic Agents, Immunological* / therapeutic use
  • Drug Approval
  • Hematologic Neoplasms / therapy*
  • Humans
  • Immunotherapy, Adoptive / adverse effects*
  • Protein Kinase Inhibitors* / adverse effects
  • Protein Kinase Inhibitors* / therapeutic use

Substances

  • Antineoplastic Agents, Immunological
  • Protein Kinase Inhibitors