Highlights
- •TCZ is an effective treatment option for irAEs secondary to ICI.
- •TCZ seems to be associated with a favorable profile in terms of oncologic outcome.
- •The combination of TCZ and ICI might guarantee the control of both cancer and irAEs.
Abstract
Objective
Research is moving towards a more personalized management of immune-related adverse
events (irAEs) due to immune checkpoint inhibitors (ICI). Our objective was to evaluate
the efficacy and safety of tocilizumab in the treatment of these clinical manifestations.
Methods
A systematic literature review was performed to retrieve data about the use of tocilizumab
in the treatment of irAEs. Additionally, data from cancer patients referred to our
Immune-related Adverse Event Clinic and treated with tocilizumab were collected.
Results
Our literature review identified 20 articles and 11 meeting abstracts. Data about
91 cancer patients who received tocilizumab for the treatment of irAEs were collected.
In 85% of cases, this therapy was associated with clinical benefit and no case of
disease progression was reported. ICI therapy was continued following irAE onset and
biologic therapy initiation in only three patients.
Five patients developed irAEs upon ICI initiation and were subsequently treated with
tocilizumab at our Centre. At a median follow-up of eight months, tocilizumab was
safely continued along with ICI in three out of five patients, and an adequate control
of irAE was obtained in all cases. No significant adverse reactions to tocilizumab
were reported. Only one patient experienced a disease progression 18 months after
ICI discontinuation.
Conclusion
Both our systematic literature review and case series highlight the efficacy and safety
of tocilizumab in the treatment of irAEs. Furthermore, they both support the possibility
of a combined approach with tocilizumab and ICI, to guarantee an effective irAEs management
without losing the oncologic response.
Keywords
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Article info
Publication history
Published online: August 12, 2021
Accepted:
July 20,
2021
Received in revised form:
July 12,
2021
Received:
May 31,
2021
Footnotes
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors
Identification
Copyright
© 2021 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
