New Immunotherapies in Oncology Treatment and Their Side Effect Profiles

J Am Board Fam Med. 2018 Jul-Aug;31(4):620-627. doi: 10.3122/jabfm.2018.04.170387.

Abstract

Background: Immunotherapies in cancer treatment have a long history going all the way back to the very beginning of the field, and recent advances are extremely promising. These therapies are becoming a larger part in many patients' oncology treatment as the number of approaches, individual medicines, and indications increase. Furthermore, these novel therapies have different side effect profiles from those traditional chemotherapies which have, until recently, typified the oncologist's approach to treatment together with surgery and radiation.

Methods: An electronic literature search was conducted in May and June 2017 and March 2018 with the PubMed and Ebscohost databases. Articles were chosen for their relevance to the drugs in question, cancer physiology, or historic significance.

Conclusions: Checkpoint inhibitors are becoming very common and possess autoimmune side effects such as pneumonitis, hypothyroidism, and colitis. These may present at any time the patient is on the medications but are more common several weeks to several months from beginning therapy. Chimeric antigen receptor T-cell therapies are powerful but have strong side effects such as cytokine release syndrome. Neoantigens are currently in the early stages of clinical trials and may become an exciting avenue for personalized cancer treatment but are not yet typical.

Keywords: Antigen Receptors; Cancer; Immunotherapy; Oncologists.

Publication types

  • Review

MeSH terms

  • Antigens, Neoplasm / administration & dosage
  • Antigens, Neoplasm / adverse effects
  • Antineoplastic Agents, Immunological / administration & dosage
  • Antineoplastic Agents, Immunological / adverse effects*
  • Clinical Trials as Topic
  • Colitis / epidemiology
  • Colitis / immunology
  • Costimulatory and Inhibitory T-Cell Receptors / antagonists & inhibitors*
  • Costimulatory and Inhibitory T-Cell Receptors / immunology
  • Cytokines / immunology
  • Cytokines / metabolism
  • Humans
  • Hypothyroidism / epidemiology
  • Hypothyroidism / immunology
  • Immune System Diseases / epidemiology
  • Immune System Diseases / immunology
  • Immunotherapy, Adoptive / adverse effects*
  • Neoplasms / immunology
  • Neoplasms / therapy*
  • Pneumonia / epidemiology
  • Pneumonia / immunology
  • Receptors, Chimeric Antigen / immunology
  • Treatment Outcome

Substances

  • Antigens, Neoplasm
  • Antineoplastic Agents, Immunological
  • Costimulatory and Inhibitory T-Cell Receptors
  • Cytokines
  • Receptors, Chimeric Antigen