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immune-related adverse events

Tuesday 23 August 2016

immune-related adverse event; irAEs

Immune checkpoint inhibition with the anti-CTLA-4 antibody ipilimumab and the anti-PD-1 antibodies nivolumab and pembrolizumab has improved survival in metastatic melanoma, lung cancer and renal cancer.

Use of these agents holds promise in other malignancies. The augmented immune response enabled by these agents has led to a particular group of side effects called immune-related adverse events (irAEs).

The main irAEs include :
- diarrhea ,
- colitis ,
- hepatitis ,
- skin toxicities
- endocrinopathies such as hypophysitis and thyroid dysfunction.

The anti-PD-1 antibodies have a different toxicity profile to ipilimumab with fewer high grade events.

Open references

- Managing immune checkpoint-blocking antibody side effects.
Postow MA.
Am Soc Clin Oncol Educ Book. 2015:76-83. doi : 10.14694/EdBook_AM.2015.35.76
PMID: 25993145

- Identification and management of toxicities from immune checkpoint-blocking drugs. Teply BA, Lipson EJ.
Oncology (Williston Park). 2014 Nov;28 Suppl 3:30-8.
PMID: 25384885

Paywall references

- Management of toxicities of immune checkpoint inhibitors. Spain L, Diem S, Larkin J. Cancer Treat Rev. 2016 Mar;44:51-60. doi : 10.1016/j.ctrv.2016.02.001 PMID: 26874776