[Management of toxicities from immunotherapy]

Dtsch Med Wochenschr. 2021 Sep;146(17):1119-1128. doi: 10.1055/a-1303-8780. Epub 2021 Aug 26.
[Article in German]

Abstract

Immunotherapy with checkpoint inhibitors - monoclonal antibodies targeting cytotoxic T lymphocyte-associated antigen 4 (CTLA4) or the programmed death-1 receptor (PD-1) and its ligand PD-L1 - is now standard of care in the treatment of patients with various tumor types. Therefore, the management of immune-related adverse events (irAEs) has become part of clinical routine.Immune-related adverse events can involve any organ or tissue. They can occur very early within days or weeks after initiation of treatment but can also occur months into treatment and after termination of treatment. Newest data suggest that irAEs can occur until 2 years after stopping therapy.Immune-related adverse events are graded according to Common Terminology Criteria for Adverse Events (CTCAE). Treatment ranges from local or symptomatic treatment, systemic application of corticosteroids to other immunosuppressive agents according to severity.The following article seeks to give a general approach to the management of patients receiving immunotherapy and experiencing irAEs including prevention, diagnostics and treatment.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • Antineoplastic Agents, Immunological / adverse effects*
  • CTLA-4 Antigen / drug effects*
  • Humans
  • Immunotherapy / adverse effects*
  • Neoplasms / therapy*
  • Programmed Cell Death 1 Receptor / drug effects*
  • Standard of Care

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents, Immunological
  • CTLA-4 Antigen
  • CTLA4 protein, human
  • Programmed Cell Death 1 Receptor