Immune Checkpoint Inhibitor Rechallenge After Prior Immune Toxicity

Curr Treat Options Oncol. 2022 Sep;23(9):1153-1168. doi: 10.1007/s11864-022-00995-9. Epub 2022 Jul 25.

Abstract

Immune checkpoint inhibitors (ICIs) have become an essential part of treatment for many cancer types. These monoclonal antibodies remove a critical negative regulatory signal that allows the immune system to recognize and destroy malignant cells that were previously undetectable. Unfortunately, their use has ushered in a whole new form of drug toxicity whereby the immune system attacks normal tissues in the body, referred to hereafter as immune-related adverse events (irAEs). irAEs are common and can result in treatment discontinuation, hospitalization, and death. When alternative modes of treatment are limited, or considered less efficacious, there may be a desire to resume treatment with ICIs after an irAE. Rechallenge with ICIs carries with it a heightened risk of subsequent toxicity, but with careful consideration and appropriate patient selection, this can be considered a reasonable approach.

Keywords: CTLA-4; Immune-related adverse event; Immunotherapy; PD-1; PD-L1; Rechallenge.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / adverse effects
  • Antineoplastic Agents, Immunological* / adverse effects
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects
  • Neoplasms* / drug therapy

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents, Immunological
  • Immune Checkpoint Inhibitors