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Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group

Cancer immunotherapy has transformed the treatment of cancer. However, increasing use of immune-based therapies, including the widely used class of agents known as immune checkpoint inhibitors, has exposed a discrete group of immune-related adverse events (irAEs). Many of these are driven by the sam...

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Autores principales: Puzanov, I., Diab, A., Abdallah, K., Bingham, C. O., Brogdon, C., Dadu, R., Hamad, L., Kim, S., Lacouture, M. E., LeBoeuf, N. R., Lenihan, D., Onofrei, C., Shannon, V., Sharma, R., Silk, A. W., Skondra, D., Suarez-Almazor, M. E., Wang, Y., Wiley, K., Kaufman, H. L., Ernstoff, M. S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697162/
https://www.ncbi.nlm.nih.gov/pubmed/29162153
http://dx.doi.org/10.1186/s40425-017-0300-z
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author Puzanov, I.
Diab, A.
Abdallah, K.
Bingham, C. O.
Brogdon, C.
Dadu, R.
Hamad, L.
Kim, S.
Lacouture, M. E.
LeBoeuf, N. R.
Lenihan, D.
Onofrei, C.
Shannon, V.
Sharma, R.
Silk, A. W.
Skondra, D.
Suarez-Almazor, M. E.
Wang, Y.
Wiley, K.
Kaufman, H. L.
Ernstoff, M. S.
author_facet Puzanov, I.
Diab, A.
Abdallah, K.
Bingham, C. O.
Brogdon, C.
Dadu, R.
Hamad, L.
Kim, S.
Lacouture, M. E.
LeBoeuf, N. R.
Lenihan, D.
Onofrei, C.
Shannon, V.
Sharma, R.
Silk, A. W.
Skondra, D.
Suarez-Almazor, M. E.
Wang, Y.
Wiley, K.
Kaufman, H. L.
Ernstoff, M. S.
author_sort Puzanov, I.
collection PubMed
description Cancer immunotherapy has transformed the treatment of cancer. However, increasing use of immune-based therapies, including the widely used class of agents known as immune checkpoint inhibitors, has exposed a discrete group of immune-related adverse events (irAEs). Many of these are driven by the same immunologic mechanisms responsible for the drugs’ therapeutic effects, namely blockade of inhibitory mechanisms that suppress the immune system and protect body tissues from an unconstrained acute or chronic immune response. Skin, gut, endocrine, lung and musculoskeletal irAEs are relatively common, whereas cardiovascular, hematologic, renal, neurologic and ophthalmologic irAEs occur much less frequently. The majority of irAEs are mild to moderate in severity; however, serious and occasionally life-threatening irAEs are reported in the literature, and treatment-related deaths occur in up to 2% of patients, varying by ICI. Immunotherapy-related irAEs typically have a delayed onset and prolonged duration compared to adverse events from chemotherapy, and effective management depends on early recognition and prompt intervention with immune suppression and/or immunomodulatory strategies. There is an urgent need for multidisciplinary guidance reflecting broad-based perspectives on how to recognize, report and manage organ-specific toxicities until evidence-based data are available to inform clinical decision-making. The Society for Immunotherapy of Cancer (SITC) established a multidisciplinary Toxicity Management Working Group, which met for a full-day workshop to develop recommendations to standardize management of irAEs. Here we present their consensus recommendations on managing toxicities associated with immune checkpoint inhibitor therapy. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40425-017-0300-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-56971622017-12-01 Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group Puzanov, I. Diab, A. Abdallah, K. Bingham, C. O. Brogdon, C. Dadu, R. Hamad, L. Kim, S. Lacouture, M. E. LeBoeuf, N. R. Lenihan, D. Onofrei, C. Shannon, V. Sharma, R. Silk, A. W. Skondra, D. Suarez-Almazor, M. E. Wang, Y. Wiley, K. Kaufman, H. L. Ernstoff, M. S. J Immunother Cancer Position Article and Guidelines Cancer immunotherapy has transformed the treatment of cancer. However, increasing use of immune-based therapies, including the widely used class of agents known as immune checkpoint inhibitors, has exposed a discrete group of immune-related adverse events (irAEs). Many of these are driven by the same immunologic mechanisms responsible for the drugs’ therapeutic effects, namely blockade of inhibitory mechanisms that suppress the immune system and protect body tissues from an unconstrained acute or chronic immune response. Skin, gut, endocrine, lung and musculoskeletal irAEs are relatively common, whereas cardiovascular, hematologic, renal, neurologic and ophthalmologic irAEs occur much less frequently. The majority of irAEs are mild to moderate in severity; however, serious and occasionally life-threatening irAEs are reported in the literature, and treatment-related deaths occur in up to 2% of patients, varying by ICI. Immunotherapy-related irAEs typically have a delayed onset and prolonged duration compared to adverse events from chemotherapy, and effective management depends on early recognition and prompt intervention with immune suppression and/or immunomodulatory strategies. There is an urgent need for multidisciplinary guidance reflecting broad-based perspectives on how to recognize, report and manage organ-specific toxicities until evidence-based data are available to inform clinical decision-making. The Society for Immunotherapy of Cancer (SITC) established a multidisciplinary Toxicity Management Working Group, which met for a full-day workshop to develop recommendations to standardize management of irAEs. Here we present their consensus recommendations on managing toxicities associated with immune checkpoint inhibitor therapy. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40425-017-0300-z) contains supplementary material, which is available to authorized users. BioMed Central 2017-11-21 /pmc/articles/PMC5697162/ /pubmed/29162153 http://dx.doi.org/10.1186/s40425-017-0300-z Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Position Article and Guidelines
Puzanov, I.
Diab, A.
Abdallah, K.
Bingham, C. O.
Brogdon, C.
Dadu, R.
Hamad, L.
Kim, S.
Lacouture, M. E.
LeBoeuf, N. R.
Lenihan, D.
Onofrei, C.
Shannon, V.
Sharma, R.
Silk, A. W.
Skondra, D.
Suarez-Almazor, M. E.
Wang, Y.
Wiley, K.
Kaufman, H. L.
Ernstoff, M. S.
Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group
title Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group
title_full Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group
title_fullStr Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group
title_full_unstemmed Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group
title_short Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group
title_sort managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the society for immunotherapy of cancer (sitc) toxicity management working group
topic Position Article and Guidelines
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697162/
https://www.ncbi.nlm.nih.gov/pubmed/29162153
http://dx.doi.org/10.1186/s40425-017-0300-z
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