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Immune-related adverse events during anticancer immunotherapy: Pathogenesis and management

Immunotherapy is one of the most recent systemic treatments to emerge for use in oncology, and is based on the blocking of inhibitory immune checkpoints to potentiate the immune response to cancer. The anti-cytotoxic T lymphocyte-associated antigen-4 antibody ipilimumab and anti-programmed cell deat...

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Autores principales: Stucci, Stefania, Palmirotta, Raffaele, Passarelli, Anna, Silvestris, Erica, Argentiero, Antonella, Lanotte, Laura, Acquafredda, Silvana, Todisco, Annalisa, Silvestris, Franco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: D.A. Spandidos 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661371/
https://www.ncbi.nlm.nih.gov/pubmed/29113194
http://dx.doi.org/10.3892/ol.2017.6919
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author Stucci, Stefania
Palmirotta, Raffaele
Passarelli, Anna
Silvestris, Erica
Argentiero, Antonella
Lanotte, Laura
Acquafredda, Silvana
Todisco, Annalisa
Silvestris, Franco
author_facet Stucci, Stefania
Palmirotta, Raffaele
Passarelli, Anna
Silvestris, Erica
Argentiero, Antonella
Lanotte, Laura
Acquafredda, Silvana
Todisco, Annalisa
Silvestris, Franco
author_sort Stucci, Stefania
collection PubMed
description Immunotherapy is one of the most recent systemic treatments to emerge for use in oncology, and is based on the blocking of inhibitory immune checkpoints to potentiate the immune response to cancer. The anti-cytotoxic T lymphocyte-associated antigen-4 antibody ipilimumab and anti-programmed cell death protein 1 antibodies, including nivolumab and pembrolizumab, are currently available and widely used, and other immune-inhibiting antibodies are now under intensive investigation. These antibodies have shown efficacy in a growing number of tumor types, following initial observations of their notable effects in melanoma treatment. Despite the efficacy of these antibodies, their novel mechanisms of action are also associated with a new class of side effects called immune-related adverse events (IRAEs). These side effects do not share a common pathophysiology with other anticancer treatments and, therefore, they often require specific therapies. When detected early and correctly treated, IRAEs are reversible; however, they can become severe and life-threatening if underestimated or inappropriately treated. This review aims to revisit the pathogenesis of IRAEs, with attention to gastrointestinal manifestations, since these are common and potentially dangerous complications of immunotherapy and represent a major cause of treatment discontinuation. Recommendations and guidelines for the management of IRAEs are also presented, in order to provide a clear and applicable algorithm for use by clinicians.
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spelling pubmed-56613712017-11-06 Immune-related adverse events during anticancer immunotherapy: Pathogenesis and management Stucci, Stefania Palmirotta, Raffaele Passarelli, Anna Silvestris, Erica Argentiero, Antonella Lanotte, Laura Acquafredda, Silvana Todisco, Annalisa Silvestris, Franco Oncol Lett Review Immunotherapy is one of the most recent systemic treatments to emerge for use in oncology, and is based on the blocking of inhibitory immune checkpoints to potentiate the immune response to cancer. The anti-cytotoxic T lymphocyte-associated antigen-4 antibody ipilimumab and anti-programmed cell death protein 1 antibodies, including nivolumab and pembrolizumab, are currently available and widely used, and other immune-inhibiting antibodies are now under intensive investigation. These antibodies have shown efficacy in a growing number of tumor types, following initial observations of their notable effects in melanoma treatment. Despite the efficacy of these antibodies, their novel mechanisms of action are also associated with a new class of side effects called immune-related adverse events (IRAEs). These side effects do not share a common pathophysiology with other anticancer treatments and, therefore, they often require specific therapies. When detected early and correctly treated, IRAEs are reversible; however, they can become severe and life-threatening if underestimated or inappropriately treated. This review aims to revisit the pathogenesis of IRAEs, with attention to gastrointestinal manifestations, since these are common and potentially dangerous complications of immunotherapy and represent a major cause of treatment discontinuation. Recommendations and guidelines for the management of IRAEs are also presented, in order to provide a clear and applicable algorithm for use by clinicians. D.A. Spandidos 2017-11 2017-09-08 /pmc/articles/PMC5661371/ /pubmed/29113194 http://dx.doi.org/10.3892/ol.2017.6919 Text en Copyright: © Stucci et al. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Review
Stucci, Stefania
Palmirotta, Raffaele
Passarelli, Anna
Silvestris, Erica
Argentiero, Antonella
Lanotte, Laura
Acquafredda, Silvana
Todisco, Annalisa
Silvestris, Franco
Immune-related adverse events during anticancer immunotherapy: Pathogenesis and management
title Immune-related adverse events during anticancer immunotherapy: Pathogenesis and management
title_full Immune-related adverse events during anticancer immunotherapy: Pathogenesis and management
title_fullStr Immune-related adverse events during anticancer immunotherapy: Pathogenesis and management
title_full_unstemmed Immune-related adverse events during anticancer immunotherapy: Pathogenesis and management
title_short Immune-related adverse events during anticancer immunotherapy: Pathogenesis and management
title_sort immune-related adverse events during anticancer immunotherapy: pathogenesis and management
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661371/
https://www.ncbi.nlm.nih.gov/pubmed/29113194
http://dx.doi.org/10.3892/ol.2017.6919
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