Multidisciplinary Clinical Approach to Cancer Patients with Immune-Related Adverse Events Induced by Checkpoint Inhibitors

被引:25
作者
Londono, Maria-Carlota [1 ]
Reig, Maria [2 ]
机构
[1] Univ Barcelona, Hosp Clin Barcelona, Liver Unit, IDIBAPS,CIBERehd, Barcelona 08036, Spain
[2] Univ Barcelona, Hosp Clin Barcelona, Liver Canc Grp BCLC, Liver Unit,IDIBAPS,CIBERehd, Barcelona 08036, Spain
关键词
immune checkpoint inhibitors; immune-oncology; immune-related adverse events; protocols; multidisciplinary approach; MYASTHENIA-GRAVIS; CLINICOPATHOLOGICAL FEATURES; ADVANCED MELANOMA; NIVOLUMAB; PD-1; IPILIMUMAB; MANAGEMENT; IMMUNOTHERAPY; MYOSITIS; COLITIS;
D O I
10.3390/cancers12113446
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Simple Summary This manuscript revises the harmonised management of side effects related to the use of certain drugs to treat cancer called checkpoint inhibitors. These drugs activate immune responses against tumour cells and by doing so they may also induce immune responses against self-tissues leading to clinical manifestations that affect several organs and systems. The complexity of this scenario requires a multidisciplinary care, integrating several health professionals (specialized nurses, prescribers, and non-prescriber specialists) that consider all treatment options and develop an individual treatment plan for each patient aiming to guarantee the best patient care. The recommendations presented here are based on current guidelines for the management of organ-specific immune-related adverse events. Immune-oncology is a major breakthrough in cancer treatment and has become the standard of care for a wide variety of solid organ malignancies. Unfortunately, manipulation of the immune system with checkpoint inhibitors may result in an immune-based attack of normal tissues which can lead to treatment discontinuation. These immune-related adverse events (irAEs) are diverse and affect several organs, constituting a new clinical challenge in the management of cancer patients. The complexity of this scenario requires a multidisciplinary approach that allows the early identification, diagnosis and treatment of specific irAE, ruling out other non-related adverse events. Hospital Clinic has a multidisciplinary team seeking to develop a coordinated strategy to facilitate the access of patients with suspected irAEs to specialised care resulting in harmonised management that guarantees the best patient care. The aim of the manuscript was to describe the current evidence on the management of irAEs reflecting a coordinated multidisciplinary approach to face this clinical challenge regardless of the immunotherapy indication.
引用
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页码:1 / 22
页数:22
相关论文
共 112 条
  • [1] Use of Immune Checkpoint Inhibitors in the Treatment of Patients With Cancer and Preexisting Autoimmune Disease A Systematic Review
    Abdel-Wahab, Noha
    Shah, Mohsin
    Lopez-Olivo, Maria A.
    Suarez-Almazor, Maria E.
    [J]. ANNALS OF INTERNAL MEDICINE, 2018, 168 (02) : 121 - +
  • [2] Outcomes of vedolizumab therapy in patients with immune checkpoint inhibitor-induced colitis: a multi-center study
    Abu-Sbeih, Hamzah
    Ali, Faisal S.
    Alsaadi, Dana
    Jennings, Joseph
    Luo, Wenyi
    Gong, Zimu
    Richards, David M.
    Charabaty, Aline
    Wang, Yinghong
    [J]. JOURNAL FOR IMMUNOTHERAPY OF CANCER, 2018, 6
  • [3] Importance of endoscopic and histological evaluation in the management of immune checkpoint inhibitor-induced colitis
    Abu-Sbeih, Hamzah
    Ali, Faisal S.
    Luo, Wenyi
    Qiao, Wei
    Raju, Gottumukkala S.
    Wang, Yinghong
    [J]. JOURNAL FOR IMMUNOTHERAPY OF CANCER, 2018, 6
  • [4] Birdshot-like Chorioretinopathy Associated With Pembrolizumab Treatment
    Acaba-Berrocal, Luis A.
    Lucio-Alvarez, J. Antonio
    Mashayekhi, Arman
    Ho, Allen C.
    Dunn, James P.
    Shields, Carol L.
    [J]. JAMA OPHTHALMOLOGY, 2018, 136 (10) : 1205 - 1207
  • [5] EASL Clinical Practice Guidelines: Drug-induced liver injury
    Andrade, Raul J.
    Aithal, Guruprasad P.
    Bjornsson, Einar S.
    Kaplowitz, Neil
    Kullak-Ublick, Gerd A.
    Karlsen, Tom H.
    [J]. JOURNAL OF HEPATOLOGY, 2019, 70 (06) : 1222 - 1261
  • [6] Immune Checkpoint Inhibitor-Associated Myositis: Expanding the Spectrum of Cardiac Complications of the Immunotherapy Revolution
    Anquetil, Celine
    Salem, Joe-Elie
    Lebrun-Vignes, Benedicte
    Johnson, Douglas B.
    Mammen, Andrew L.
    Stenzel, Werner
    Leonard-Louis, Sarah
    Benveniste, Olivier
    Moslehi, Javid J.
    Allenbach, Yves
    [J]. CIRCULATION, 2018, 138 (07) : 743 - 745
  • [7] A systematic review of adverse events in randomized trials assessing immune checkpoint inhibitors
    Arnaud-Coffin, Patrick
    Maillet, Denis
    Gan, Hui K.
    Stelmes, Jean-Jacques
    You, Benoit
    Dalle, Stephane
    Peron, Julien
    [J]. INTERNATIONAL JOURNAL OF CANCER, 2019, 145 (03) : 639 - 648
  • [8] Molecular targeted therapy-related life-threatening toxicity in patients with malignancies. A systematic review of published cases
    Assoun, Sandra
    Lemiale, Virginie
    Azoulay, Elie
    [J]. INTENSIVE CARE MEDICINE, 2019, 45 (07) : 988 - 997
  • [9] Preserved Renal-Allograft Function and the PD-1 Pathway Inhibitor Nivolumab
    Barnett, Richard
    Barta, Valerie S.
    Jhaveri, Kenar D.
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2017, 376 (02) : 191 - 192
  • [10] Vedolizumab treatment for immune checkpoint inhibitor-induced enterocolitis
    Bergqvist, Viktoria
    Hertervig, Erik
    Gedeon, Peter
    Kopljar, Marija
    Griph, Hakan
    Kinhult, Sara
    Carneiro, Ana
    Marsal, Jan
    [J]. CANCER IMMUNOLOGY IMMUNOTHERAPY, 2017, 66 (05) : 581 - 592