Multidisciplinary Clinical Approach to Cancer Patients with Immune-Related Adverse Events Induced by Checkpoint Inhibitors

SIMPLE SUMMARY: This manuscript revises the harmonised management of side effects related to the use of certain drugs to treat cancer called checkpoint inhibitors. These drugs activate immune responses against tumour cells and by doing so they may also induce immune responses against self-tissues leading to clinical manifestations that affect several organs and systems. The complexity of this scenario requires a multidisciplinary care, integrating several health professionals (specialized nurses, prescribers, and non-prescriber specialists) that consider all treatment options and develop an individual treatment plan for each patient aiming to guarantee the best patient care. The recommendations presented here are based on current guidelines for the management of organ-specific immune-related adverse events. ABSTRACT: Immune-oncology is a major breakthrough in cancer treatment and has become the standard of care for a wide variety of solid organ malignancies. Unfortunately, manipulation of the immune system with checkpoint inhibitors may result in an immune-based attack of normal tissues which can lead to treatment discontinuation. These immune-related adverse events (irAEs) are diverse and affect several organs, constituting a new clinical challenge in the management of cancer patients. The complexity of this scenario requires a multidisciplinary approach that allows the early identification, diagnosis and treatment of specific irAE, ruling out other non-related adverse events. Hospital Clinic has a multidisciplinary team seeking to develop a coordinated strategy to facilitate the access of patients with suspected irAEs to specialised care resulting in harmonised management that guarantees the best patient care. The aim of the manuscript was to describe the current evidence on the management of irAEs reflecting a coordinated multidisciplinary approach to face this clinical challenge regardless of the immunotherapy indication.