Pregledni rad
https://doi.org/10.20471/LO.2021.49.02-03.17
Short review of immunotherapy toxicity
Ivana Canjko
; Department of Oncology, University Hospital Center Osijek, Osijek, Croatia
Luka Perić
; Department of Oncology, University Hospital Center Osijek, Osijek, Croatia; Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, Croatia
Josipa Flam
; Department of Oncology, University Hospital Center Osijek, Osijek, Croatia; Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, Croatia
Maja Kovač-Barić
; Department of Oncology, University Hospital Center Osijek, Osijek, Croatia; Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, Croatia
Darko Kotromanović
; Department of Oncology, University Hospital Center Osijek, Osijek, Croatia; Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, Croatia
Nora Pušeljić
; Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, Croatia;Emergency medicine, University Hospital Center Osijek, Osijek, Croatia
Mirela Šambić-Penc
; Department of Oncology, University Hospital Center Osijek, Osijek, Croatia; Faculty of Medicine, University of J.J.Strossmayer Osijek, Osijek, Croatia
Sažetak
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.
Ključne riječi
immunotherapy; immune checkpoint inhibitors; adverse events
Hrčak ID:
267962
URI
Datum izdavanja:
22.12.2021.
Posjeta: 1.254 *