RT Journal Article
SR Electronic
T1 Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group
JF Journal for ImmunoTherapy of Cancer
JO J Immunother Cancer
FD BMJ Publishing Group Ltd
SP 95
DO 10.1186/s40425-017-0300-z
VO 5
IS 1
A1 Puzanov, I.
A1 Diab, A.
A1 Abdallah, K.
A1 Bingham, C. O.
A1 Brogdon, C.
A1 Dadu, R.
A1 Hamad, L.
A1 Kim, S.
A1 Lacouture, M. E.
A1 LeBoeuf, N. R.
A1 Lenihan, D.
A1 Onofrei, C.
A1 Shannon, V.
A1 Sharma, R.
A1 Silk, A. W.
A1 Skondra, D.
A1 Suarez-Almazor, M. E.
A1 Wang, Y.
A1 Wiley, K.
A1 Kaufman, H. L.
A1 Ernstoff, M. S.
A1 on behalf of the Society for Immunotherapy of Cancer Toxicity Management Working Group
A1 Anderson, Jeff
A1 Arrindell, Deborah
A1 Andrews, Stephanie
A1 Ballesteros, Joan
A1 Boyer, Janie
A1 Chen, Daniel
A1 Chonzi, David
A1 Cotarla, Ion
A1 Cunha, Renato
A1 Davies, Marianne
A1 Dawson, Michelle
A1 Dicker, Adam
A1 Eifler, Lisa
A1 Ferguson, Andrew
A1 Ferlini, Cristiano
A1 Frankel, Stanley
A1 Go, William
A1 Gochett, Celestine
A1 Goldberg, Jenna
A1 Goncalves, Priscila
A1 Goswami, Trishna
A1 Gregory, Nancy
A1 Gulley, James L.
A1 Hayreh, Vinny
A1 Helie, Nicole
A1 Holmes, William
A1 Hsu, Jer-Yuan
A1 Ibrahim, Ramy
A1 Larocca, Cecilia
A1 Lehman, Kimberly
A1 Ley-Acosta, Sergio
A1 Lambotte, Olivier
A1 Luke, Jason
A1 McClure, Joan
A1 Michelon, Elisabete
A1 Nakamura, Mary
A1 Patel, Kiran
A1 Piperdi, Bilal
A1 Rasheed, Zeshaan
A1 Reshef, Dan
A1 Riemer, Joanne
A1 Robert, Caroline
A1 Sarkeshik, Makan
A1 Saylors, Ann
A1 Schreiber, Judy
A1 Shafer-Weaver, Kim
A1 Sharfman, William
A1 Sharon, Elad
A1 Sherry, Richard
A1 Simonson, Cyndy
A1 Thomas, Cherry
A1 Thompson, John A.
A1 Trehu, Elizabeth
A1 Tresnan, Dina
A1 Turner, Michelle
A1 Wariabharaj, Darshan
A1 Waxman, Ian
A1 Wood, Lauren
A1 Zhang, Lin
A1 Zheng, Pan
YR 2017
UL http://jitc.bmj.com/content/5/1/95.abstract
AB 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.Abbreviations:2-D echoTwo-dimensional echocardiogram/echocardiography6MWT6 min walk testAACRAmerican Association for Cancer ResearchACCCAssociation of Community Cancer CentersACPAAnti-citrullinated protein antibodiesACTHAdrenocorticotropic hormoneADCCAntibody-dependent cell-mediated cytotoxicityADLActivities of daily livingALTAlanine aminotransferaseANAAntinuclear antibodyAnti-CCPCyclic citrullinated peptide antibodyAnti-RFAnti-rheumatoid factor (anti-RF)Anti-TNFAnti-tumor necrosis factorASCOAmerican Society of Clinical OncologyASTAspartate aminotransferaseATGAnti-thymocyte globulinBALBronchoalveolar lavageBIDTwo times dailyBNPB-type natriuretic peptideBSABody surface areaCBCComplete blood countCKCreatine kinaseCMPComplete metabolic panelCMVCytomegalovirusCNSCentral Nervous SystemCOPCryptogenic organizing pneumoniaCOPDChronic obstructive pulmonary diseaseCRPC-reactive proteinCTComputed tomographyCTCAECommon Terminology Criteria for Adverse EventsCTLA-4Cytotoxic T lymphocyte-antigen-4DICDisseminated intravascular coagulationDLCODiffusing capacity of the lungs for carbon monoxideDMARDSDisease modifying anti-rheumatic drugsDRESSDrug rash with eosinophilia and systemic symptomsEBUSEndobronchial ultrasoundECGElectrocardiogramESRErythrocyte sedimentation rateFDAU.S. Food and Drug AdministrationFDG-PETFluorodeoxyglucose positron emission tomographyFNAFine needle aspirationFOBTFecal occult blood testFreeT4Free thyroxineFSHFollicle-stimulating hormoneFVCForced vital capacityGAD65Glutamic acid decarboxylaseGCAGiant cell arteritisGIGastrointestinalHbA1cGlycated hemoglobinHBcAbHepatitis B core antibodyHBsAbHepatitis B surface antibodyHBsAgHepatitis B surface antigenHCAbHepatitis C antibodyHgbHemoglobinHIVHuman immunodeficiency virusHPHypersensitivity pneumonitisHRTHormone Replacement TherapyHSVHerpes simplex virusIBDInflammatory bowel diseaseICIsImmune checkpoint inhibitorsICUIntensive care unitIFImmunofluorescenceIgEImmunoglobulin EIgG1Immunoglobulin G1IgG4Immunoglobulin G4irAEsImmune-related adverse eventsIVIGIntravenous immunoglobulinLHLuteinizing hormoneLLNLower limit of NormalmAbsMonoclonal antibodiesMCPMetacarpophalangealMedDRAMedical Dictionary for Regulatory ActivitiesMRIMagnetic resonance imagingNCCNNational Comprehensive Cancer NetworkNCINational Cancer InstituteNIHNational Institutes of HealthNSCLCNon-small cell lung carcinomaNSIPNonspecific interstitial pneumonitisNT pro-BNPN-terminal pro B-type natriuretic peptideONSOncology Nursing SocietyPASIpsoriasis area severity indexPCRPolymerase chain reactionPD-1Programmed cell death protein-1PD-L1Programmed cell death-ligand 1PFPulmonary fibrosisPFTsPulmonary function testsPIPProximal interphalangealPMRPolymyalgia rheumaticPRESPosterior Reversible Encephalopathy SyndromeQIDFour times dailyRARheumatoid arthritisRAIUSRadioactive iodine uptake scanSITCSociety for Immunotherapy of CancerSJS/TENStevens-Johnson Syndrome/toxic epidermal necrolysisSLESystemic lupus erythematosusT1DMType I DiabetesT3TriiodothyronineTBBxTransbronchial lung biopsyTcTechnetiumTh17.1T helper 17 cellsTLCTotal lung capacityTNFiTumor necrosis factor inhibitorTPOThyroid peroxidaseTRAbThyroid-stimulating hormone receptor antibodyTSHThyroid-stimulating hormoneTSIThyroid-stimulating immunoglobulinUIPUsual interstitial pneumonitisULNUpper Limit of NormalUVBShort wave ultraviolet BVZVVaricella zoster virusZn-T8Zinc transporter 8