Strategies for improving the management of immune-related adverse events
With the advent of immunotherapeutic agents, durable and dramatic responses have been observed in several hard-to-treat malignancies, outlining a roadmap to conquering cancer. Immune checkpoint inhibitors (ICPi) are a class of immunotherapeutic agents that attack the tumor cells by reinvigorating th...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-10-01
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| Series: | Journal for ImmunoTherapy of Cancer |
| Online Access: | https://jitc.bmj.com/content/8/2/e001754.full |
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| author | James L Gulley Patrick Hwu Gennaro Ciliberto Aung Naing Funda Meric-Bernstam Michael B Atkins Joud Hajjar |
| author_facet | James L Gulley Patrick Hwu Gennaro Ciliberto Aung Naing Funda Meric-Bernstam Michael B Atkins Joud Hajjar |
| author_sort | James L Gulley |
| collection | DOAJ |
| description | With the advent of immunotherapeutic agents, durable and dramatic responses have been observed in several hard-to-treat malignancies, outlining a roadmap to conquering cancer. Immune checkpoint inhibitors (ICPi) are a class of immunotherapeutic agents that attack the tumor cells by reinvigorating the suppressed immune system. However, the unbridled T-cell activity disrupts the immune homeostasis and induces a unique spectrum of side effects called immune-related adverse events (irAEs) in a significant proportion of patients. These irAEs are distinct from the side effects produced by traditional chemotherapeutic agents. Although majority of irAEs are manageable with corticosteroids and other immunosuppressive agents, life-threatening and fatal events have been reported. In the absence of predictive biomarkers to identify patients at risk for irAEs and standardized approach to detect, report, and treat irAEs, management of irAEs has been challenging to the patients, caregivers and the healthcare providers alike. With increasing use of ICPis for treatment of various cancers, the incidence of irAEs will undoubtedly increase. There is a compelling need to develop measures to effectively manage irAEs, both in the community settings and in cancer centers alike. To this end, in this paper, we propose several strategies, such as providing patient education, harmonizing irAE management guidelines, standardizing reporting of irAEs, optimizing the choice of immunosuppressive agents, conducting preclinical, clinical and translational studies to better understand irAEs, including high-risk patients, incorporating diagnostic tools to personalize irAE management using wireless technology and digital health, providing a platform to hear the missing patient’s voice, and sharing evolving data to improve the management of irAEs. |
| format | Article |
| id | doaj-art-ad45af312bd64f05a2e5d1bfde341615 |
| institution | OA Journals |
| issn | 2051-1426 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Journal for ImmunoTherapy of Cancer |
| spelling | doaj-art-ad45af312bd64f05a2e5d1bfde3416152025-08-20T02:13:22ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262020-10-018210.1136/jitc-2020-001754Strategies for improving the management of immune-related adverse eventsJames L Gulley0Patrick Hwu1Gennaro Ciliberto2Aung Naing3Funda Meric-Bernstam4Michael B Atkins5Joud Hajjar67 Center for Immuno-Oncology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA4 Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USAScientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, ItalyDepartment of Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA1 Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA4 Oncology, Georgetown University, Washington, DC, USAAdult Allergy and Immunology, Baylor College of Medicine and Texas Children`s Hospital, Houston, Texas, USAWith the advent of immunotherapeutic agents, durable and dramatic responses have been observed in several hard-to-treat malignancies, outlining a roadmap to conquering cancer. Immune checkpoint inhibitors (ICPi) are a class of immunotherapeutic agents that attack the tumor cells by reinvigorating the suppressed immune system. However, the unbridled T-cell activity disrupts the immune homeostasis and induces a unique spectrum of side effects called immune-related adverse events (irAEs) in a significant proportion of patients. These irAEs are distinct from the side effects produced by traditional chemotherapeutic agents. Although majority of irAEs are manageable with corticosteroids and other immunosuppressive agents, life-threatening and fatal events have been reported. In the absence of predictive biomarkers to identify patients at risk for irAEs and standardized approach to detect, report, and treat irAEs, management of irAEs has been challenging to the patients, caregivers and the healthcare providers alike. With increasing use of ICPis for treatment of various cancers, the incidence of irAEs will undoubtedly increase. There is a compelling need to develop measures to effectively manage irAEs, both in the community settings and in cancer centers alike. To this end, in this paper, we propose several strategies, such as providing patient education, harmonizing irAE management guidelines, standardizing reporting of irAEs, optimizing the choice of immunosuppressive agents, conducting preclinical, clinical and translational studies to better understand irAEs, including high-risk patients, incorporating diagnostic tools to personalize irAE management using wireless technology and digital health, providing a platform to hear the missing patient’s voice, and sharing evolving data to improve the management of irAEs.https://jitc.bmj.com/content/8/2/e001754.full |
| spellingShingle | James L Gulley Patrick Hwu Gennaro Ciliberto Aung Naing Funda Meric-Bernstam Michael B Atkins Joud Hajjar Strategies for improving the management of immune-related adverse events Journal for ImmunoTherapy of Cancer |
| title | Strategies for improving the management of immune-related adverse events |
| title_full | Strategies for improving the management of immune-related adverse events |
| title_fullStr | Strategies for improving the management of immune-related adverse events |
| title_full_unstemmed | Strategies for improving the management of immune-related adverse events |
| title_short | Strategies for improving the management of immune-related adverse events |
| title_sort | strategies for improving the management of immune related adverse events |
| url | https://jitc.bmj.com/content/8/2/e001754.full |
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