Adverse effects of immune-checkpoint inhibitors: epidemiology, management and surveillance

Immune-checkpoint inhibitors (ICIs), including anti-cytotoxic T lymphocyte antigen 4 (CTLA-4), anti-programmed cell death 1 (PD-1) and anti-programmed cell death 1 ligand 1 (PD-L1) antibodies, are arguably the most important development in cancer therapy over the past decade. The indications for the...

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Published in:Nature reviews. Clinical oncology Vol. 16; no. 9; pp. 563 - 580
Main Authors: Martins, Filipe, Sofiya, Latifyan, Sykiotis, Gerasimos P, Lamine, Faiza, Maillard, Michel, Fraga, Montserrat, Shabafrouz, Keyvan, Ribi, Camillo, Cairoli, Anne, Guex-Crosier, Yan, Kuntzer, Thierry, Michielin, Olivier, Peters, Solange, Coukos, Georges, Spertini, Francois, Thompson, John A, Obeid, Michel
Format: Journal Article
Language:English
Published: England Nature Publishing Group 01.09.2019
Subjects:
Adverse events
Antineoplastic Agents, Immunological - adverse effects
Apoptosis
Biopsy
Cancer therapies
Cell death
Chemotherapy
CTLA-4 protein
Cytotoxicity
Drug-Related Side Effects and Adverse Reactions - diagnosis
Drug-Related Side Effects and Adverse Reactions - epidemiology
Drug-Related Side Effects and Adverse Reactions - therapy
Epidemiology
Humans
Immune checkpoint inhibitors
Immunologic Factors - adverse effects
Immunotherapy - adverse effects
Immunotherapy - methods
Inflammation
Lymphocytes T
Malignancy
Management
Neoplasms - drug therapy
Oncology
Patients
PD-1 protein
PD-L1 protein
Risk factors
Risk groups
Side effects
Surveillance
ISSN:1759-4774, 1759-4782, 1759-4782
Online Access:Get full text
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Summary:Immune-checkpoint inhibitors (ICIs), including anti-cytotoxic T lymphocyte antigen 4 (CTLA-4), anti-programmed cell death 1 (PD-1) and anti-programmed cell death 1 ligand 1 (PD-L1) antibodies, are arguably the most important development in cancer therapy over the past decade. The indications for these agents continue to expand across malignancies and disease settings, thus reshaping many of the previous standard-of-care approaches and bringing new hope to patients. One of the costs of these advances is the emergence of a new spectrum of immune-related adverse events (irAEs), which are often distinctly different from the classical chemotherapy-related toxicities. Owing to the growing use of ICIs in oncology, clinicians will increasingly be confronted with common but also rare irAEs; hence, awareness needs to be raised regarding the clinical presentation, diagnosis and management of these toxicities. In this Review, we provide an overview of the various types of irAEs that have emerged to date. We discuss the epidemiology of these events and their kinetics, risk factors, subtypes and pathophysiology, as well as new insights regarding screening and surveillance strategies. We also highlight the most important aspects of the management of irAEs.
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ISSN:1759-4774
1759-4782
1759-4782
DOI:10.1038/s41571-019-0218-0