Immune Checkpoint Inhibitor Toxicity Review for the Palliative Care Clinician

J Pain Symptom Manage. 2018 Sep;56(3):460-472. doi: 10.1016/j.jpainsymman.2018.05.015. Epub 2018 May 22.

Abstract

Immune checkpoint inhibitors (ICIs) have opened an exciting chapter in the treatment of patients with advanced cancer. For the palliative care clinician, however, ICIs present several new challenges, including new ways to define treatment success, as well as treatment-related toxicities that differ in nature and timing from traditional chemotherapy. In this article, we review the mechanism of action of ICIs, as well as selected published data supporting the efficacy of ICIs in patients with advanced cancer. In addition, we summarize existing data of ICI toxicity prevalence, patterns of severity, and timing of onset. Finally, we briefly review key principles from published guidelines on the management of ICI toxicities.

Keywords: Immunotherapy; checkpoint inhibition; immune-related adverse events; toxicity.

Publication types

  • Review

MeSH terms

  • Humans
  • Immunologic Factors / adverse effects*
  • Immunologic Factors / therapeutic use
  • Immunologic Factors / toxicity*
  • Immunotherapy / adverse effects*
  • Neoplasms / epidemiology
  • Neoplasms / immunology
  • Neoplasms / therapy
  • Palliative Care*
  • Physicians

Substances

  • Immunologic Factors