Highlights
- •Immunotherapy blocks inhibitory immune checkpoints allowing our immune system to fight against tumor cells.
- •Most frequent irAEs affect skin, gastrointestinal, liver, lung and endocrine systems.
- •Timely intervention with corticosteroids is crucial to limit the severity of irAEs.
- •Corticosteroids are generally indicated together with dose skipping or discontinuation for persistent grade ≥2 irAEs.
- •Severe irAEs, grade 3-4, may require additional immunosuppressive agents and a multidisciplinary approach.
Abstract
Over the last decade anticancer treatment has experienced encouraging changes. One
of the latest developments is immunotherapy, which is increasingly becoming a mainstay
for the treatment of these malignancies. Unlike conventional chemotherapy, immunotherapy
enhances anti-tumor immune response by blocking inhibitory immune checkpoints, and
allowing our own immune system to fight against the tumor cells, arising as a new
and innovative mechanism of action. Therefore, although well tolerated, these drugs
have a unique side effect profile and are known to cause immune-related adverse events
(irAEs). Adverse effects of immunotherapy are most commonly observed in the skin,
gastrointestinal tract, liver, lung and endocrine systems. Less common toxicities
may include neurological, haematological, cardiac, ocular or rheumatologic involvement.
As far as we know, cancer patients are frequently seen in the Emergency Department
due to treatment related toxicities, thus there is an increasing necessity to learn
about this particular side effect profile
given that they entail a different and unique management than that of classic chemotherapy
drugs.
Keywords
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Article info
Publication history
Published online: May 23, 2019
Accepted:
May 16,
2019
Received in revised form:
May 3,
2019
Received:
March 18,
2019
Identification
Copyright
© 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
