Short review of immunotherapy toxicity
Immune checkpoint inhibitors, such as CTLA-4 inhibitors (ipilimumab), PD-1 (nivolumab, pembrolizumab), and PDL1 inhibitors (atezolizumab, durvalumab) have become standard in the treatment of numerous malignant tumors. Immunotherapy blocks the body’s natural protective measures with immune checkpoin...
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| Format: | Article |
| Language: | English |
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University Hospital for Tumors
2021-01-01
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| Series: | Libri Oncologici |
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| Online Access: | https://hrcak.srce.hr/file/389037 |
| _version_ | 1827282193691443200 |
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| author | Ivana Canjko Luka Perić Josipa Flam Maja Kovač-Barić Darko Kotromanović Nora Pušeljić Mirela Šambić-Penc |
| author_facet | Ivana Canjko Luka Perić Josipa Flam Maja Kovač-Barić Darko Kotromanović Nora Pušeljić Mirela Šambić-Penc |
| author_sort | Ivana Canjko |
| collection | DOAJ |
| description | Immune checkpoint inhibitors, such as CTLA-4 inhibitors (ipilimumab), PD-1 (nivolumab, pembrolizumab), and PDL1 inhibitors (atezolizumab, durvalumab) have become standard in the treatment of numerous malignant tumors.
Immunotherapy blocks the body’s natural protective measures with immune checkpoint inhibitors. It prevents immune over-activation, but it can also affect normal tissue, and cause autoimmune side effects. They cover a diverse spectrum of events and require different treatment approaches. Immune related side effects can affect any organ or tissue, but most commonly affect the skin, colon, lungs, liver and endocrine organs (such as the pituitary or thyroid).
We can divide them according to the anatomical location where they cause side effects. Most of these side effects are mild to moderate and reversible if detected early and treated appropriately. The most common side effects of CTLA-4 inhibitor and PD-1 / PD-L1 inhibitor are skin symptoms (such as rash and itching). Gastrointestinal symptoms (such as diarrhea) are more common with CTLA-4 inhibitors, while lung symptoms and thyroid dysfunction occur more frequently with the use of PD-1/PD-L1 inhibitors.
It is important to determine the side effect, and the degree of the same to be able to treat it adequately. First-grade side effects are mild, second grade moderate, third grade severe, and fourth grade very severe. Re-administration of immunotherapy after immunotherapy in patients with significant irAE (immune-related adverse events) during initial treatment with either a CTLA-4 inhibitor and/or a PD-1 / PD-L1 checkpoint inhibitor can be safely repeated after discussing and ensuring that the patient does not experience a new serious side effect. |
| first_indexed | 2024-04-24T09:13:59Z |
| format | Article |
| id | doaj.art-9f404e622fe9476e99f416a012ee7918 |
| institution | Directory Open Access Journal |
| issn | 0300-8142 2584-3826 |
| language | English |
| last_indexed | 2024-04-24T09:13:59Z |
| publishDate | 2021-01-01 |
| publisher | University Hospital for Tumors |
| record_format | Article |
| series | Libri Oncologici |
| spelling | doaj.art-9f404e622fe9476e99f416a012ee79182024-04-15T17:24:04ZengUniversity Hospital for TumorsLibri Oncologici0300-81422584-38262021-01-01492-311812310.20471/LO.2021.49.02-03.17Short review of immunotherapy toxicityIvana Canjko0Luka Perić1Josipa Flam2Maja Kovač-Barić3Darko Kotromanović4Nora Pušeljić5Mirela Šambić-Penc6Department of Oncology, University Hospital Center Osijek, Osijek, CroatiaDepartment of Oncology, University Hospital Center Osijek, Osijek, Croatia; Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, CroatiaDepartment of Oncology, University Hospital Center Osijek, Osijek, Croatia; Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, CroatiaDepartment of Oncology, University Hospital Center Osijek, Osijek, Croatia; Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, CroatiaDepartment of Oncology, University Hospital Center Osijek, Osijek, Croatia; Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, CroatiaFaculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, Croatia;Emergency medicine, University Hospital Center Osijek, Osijek, CroatiaDepartment of Oncology, University Hospital Center Osijek, Osijek, Croatia; Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, CroatiaImmune checkpoint inhibitors, such as CTLA-4 inhibitors (ipilimumab), PD-1 (nivolumab, pembrolizumab), and PDL1 inhibitors (atezolizumab, durvalumab) have become standard in the treatment of numerous malignant tumors. Immunotherapy blocks the body’s natural protective measures with immune checkpoint inhibitors. It prevents immune over-activation, but it can also affect normal tissue, and cause autoimmune side effects. They cover a diverse spectrum of events and require different treatment approaches. Immune related side effects can affect any organ or tissue, but most commonly affect the skin, colon, lungs, liver and endocrine organs (such as the pituitary or thyroid). We can divide them according to the anatomical location where they cause side effects. Most of these side effects are mild to moderate and reversible if detected early and treated appropriately. The most common side effects of CTLA-4 inhibitor and PD-1 / PD-L1 inhibitor are skin symptoms (such as rash and itching). Gastrointestinal symptoms (such as diarrhea) are more common with CTLA-4 inhibitors, while lung symptoms and thyroid dysfunction occur more frequently with the use of PD-1/PD-L1 inhibitors. It is important to determine the side effect, and the degree of the same to be able to treat it adequately. First-grade side effects are mild, second grade moderate, third grade severe, and fourth grade very severe. Re-administration of immunotherapy after immunotherapy in patients with significant irAE (immune-related adverse events) during initial treatment with either a CTLA-4 inhibitor and/or a PD-1 / PD-L1 checkpoint inhibitor can be safely repeated after discussing and ensuring that the patient does not experience a new serious side effect.https://hrcak.srce.hr/file/389037immunotherapyimmune checkpoint inhibitorsadverse events |
| spellingShingle | Ivana Canjko Luka Perić Josipa Flam Maja Kovač-Barić Darko Kotromanović Nora Pušeljić Mirela Šambić-Penc Short review of immunotherapy toxicity Libri Oncologici immunotherapy immune checkpoint inhibitors adverse events |
| title | Short review of immunotherapy toxicity |
| title_full | Short review of immunotherapy toxicity |
| title_fullStr | Short review of immunotherapy toxicity |
| title_full_unstemmed | Short review of immunotherapy toxicity |
| title_short | Short review of immunotherapy toxicity |
| title_sort | short review of immunotherapy toxicity |
| topic | immunotherapy immune checkpoint inhibitors adverse events |
| url | https://hrcak.srce.hr/file/389037 |
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