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Clinical Characteristics and Treatment of Immune-Related Adverse Events of Immune Checkpoint Inhibitors

Immune checkpoint inhibitors (ICIs) have been changing the paradigm of cancer treatment. However, immune-related adverse effects (irAEs) have also increased with the exponential increase in the use of ICIs. ICIs can break up the immunologic homeostasis and reduce T-cell tolerance. Therefore, inhibit...

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Autores principales: Choi, Juwhan, Lee, Sung Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association of Immunologists 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049586/
https://www.ncbi.nlm.nih.gov/pubmed/32158597
http://dx.doi.org/10.4110/in.2020.20.e9
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author Choi, Juwhan
Lee, Sung Yong
author_facet Choi, Juwhan
Lee, Sung Yong
author_sort Choi, Juwhan
collection PubMed
description Immune checkpoint inhibitors (ICIs) have been changing the paradigm of cancer treatment. However, immune-related adverse effects (irAEs) have also increased with the exponential increase in the use of ICIs. ICIs can break up the immunologic homeostasis and reduce T-cell tolerance. Therefore, inhibition of immune checkpoint can lead to the activation of autoreactive T-cells, resulting in various irAEs similar to autoimmune diseases. Gastrointestinal toxicity, endocrine toxicity, and dermatologic toxicity are common side effects. Neurotoxicity, cardiotoxicity, and pulmonary toxicity are relatively rare but can be fatal. ICI-related gastrointestinal toxicity, dermatologic toxicity, and hypophysitis are more common with anti- CTLA-4 agents. ICI-related pulmonary toxicity, thyroid dysfunction, and myasthenia gravis are more common with PD-1/PD-L1 inhibitors. Treatment with systemic steroids is the principal strategy against irAEs. The use of immune-modulatory agents should be considered in case of no response to the steroid therapy. Treatment under the supervision of multidisciplinary specialists is also essential, because the symptoms and treatments of irAEs could involve many organs. Thus, this review focuses on the mechanism, clinical presentation, incidence, and treatment of various irAEs.
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spelling pubmed-70495862020-03-10 Clinical Characteristics and Treatment of Immune-Related Adverse Events of Immune Checkpoint Inhibitors Choi, Juwhan Lee, Sung Yong Immune Netw Review Article Immune checkpoint inhibitors (ICIs) have been changing the paradigm of cancer treatment. However, immune-related adverse effects (irAEs) have also increased with the exponential increase in the use of ICIs. ICIs can break up the immunologic homeostasis and reduce T-cell tolerance. Therefore, inhibition of immune checkpoint can lead to the activation of autoreactive T-cells, resulting in various irAEs similar to autoimmune diseases. Gastrointestinal toxicity, endocrine toxicity, and dermatologic toxicity are common side effects. Neurotoxicity, cardiotoxicity, and pulmonary toxicity are relatively rare but can be fatal. ICI-related gastrointestinal toxicity, dermatologic toxicity, and hypophysitis are more common with anti- CTLA-4 agents. ICI-related pulmonary toxicity, thyroid dysfunction, and myasthenia gravis are more common with PD-1/PD-L1 inhibitors. Treatment with systemic steroids is the principal strategy against irAEs. The use of immune-modulatory agents should be considered in case of no response to the steroid therapy. Treatment under the supervision of multidisciplinary specialists is also essential, because the symptoms and treatments of irAEs could involve many organs. Thus, this review focuses on the mechanism, clinical presentation, incidence, and treatment of various irAEs. The Korean Association of Immunologists 2020-02-17 /pmc/articles/PMC7049586/ /pubmed/32158597 http://dx.doi.org/10.4110/in.2020.20.e9 Text en Copyright © 2020. The Korean Association of Immunologists https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Choi, Juwhan
Lee, Sung Yong
Clinical Characteristics and Treatment of Immune-Related Adverse Events of Immune Checkpoint Inhibitors
title Clinical Characteristics and Treatment of Immune-Related Adverse Events of Immune Checkpoint Inhibitors
title_full Clinical Characteristics and Treatment of Immune-Related Adverse Events of Immune Checkpoint Inhibitors
title_fullStr Clinical Characteristics and Treatment of Immune-Related Adverse Events of Immune Checkpoint Inhibitors
title_full_unstemmed Clinical Characteristics and Treatment of Immune-Related Adverse Events of Immune Checkpoint Inhibitors
title_short Clinical Characteristics and Treatment of Immune-Related Adverse Events of Immune Checkpoint Inhibitors
title_sort clinical characteristics and treatment of immune-related adverse events of immune checkpoint inhibitors
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049586/
https://www.ncbi.nlm.nih.gov/pubmed/32158597
http://dx.doi.org/10.4110/in.2020.20.e9
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