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 I. Puzanov
A1 A. Diab
A1 K. Abdallah
A1 C. O. Bingham III
A1 C. Brogdon
A1 R. Dadu
A1 L. Hamad
A1 S. Kim
A1 M. E. Lacouture
A1 N. R. LeBoeuf
A1 D. Lenihan
A1 C. Onofrei
A1 V. Shannon
A1 R. Sharma
A1 A. W. Silk
A1 D. Skondra
A1 M. E. Suarez-Almazor
A1 Y. Wang
A1 K. Wiley
A1 H. L. Kaufman
A1 M. S. Ernstoff
A1 on behalf of the Society for Immunotherapy of Cancer Toxicity Management Working Group
A1 Jeff Anderson
A1 Deborah Arrindell
A1 Stephanie Andrews
A1 Joan Ballesteros
A1 Janie Boyer
A1 Daniel Chen
A1 David Chonzi
A1 Ion Cotarla
A1 Renato Cunha
A1 Marianne Davies
A1 Michelle Dawson
A1 Adam Dicker
A1 Lisa Eifler
A1 Andrew Ferguson
A1 Cristiano Ferlini
A1 Stanley Frankel
A1 William Go
A1 Celestine Gochett
A1 Jenna Goldberg
A1 Priscila Goncalves
A1 Trishna Goswami
A1 Nancy Gregory
A1 James L. Gulley
A1 Vinny Hayreh
A1 Nicole Helie
A1 William Holmes
A1 Jer-Yuan Hsu
A1 Ramy Ibrahim
A1 Cecilia Larocca
A1 Kimberly Lehman
A1 Sergio Ley-Acosta
A1 Olivier Lambotte
A1 Jason Luke
A1 Joan McClure
A1 Elisabete Michelon
A1 Mary Nakamura
A1 Kiran Patel
A1 Bilal Piperdi
A1 Zeshaan Rasheed
A1 Dan Reshef
A1 Joanne Riemer
A1 Caroline Robert
A1 Makan Sarkeshik
A1 Ann Saylors
A1 Judy Schreiber
A1 Kim Shafer-Weaver
A1 William Sharfman
A1 Elad Sharon
A1 Richard Sherry
A1 Cyndy Simonson
A1 Cherry Thomas
A1 John A. Thompson
A1 Elizabeth Trehu
A1 Dina Tresnan
A1 Michelle Turner
A1 Darshan Wariabharaj
A1 Ian Waxman
A1 Lauren Wood
A1 Lin Zhang
A1 Pan Zheng
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