Cancer Management and Research (Sep 2020)
Management of Immune Checkpoint Inhibitor Toxicities
Abstract
Quentin Durrechou,1 Charlotte Domblides,1,2 Baptiste Sionneau,1 Felix Lefort,1 Amandine Quivy,1 Alain Ravaud,1 Marine Gross-Goupil,1 Amaury Daste1 1Department of Medical Oncology, Hôpital Saint-André, CHU Bordeaux-University of Bordeaux, Bordeaux, France; 2ImmunoConcEpt, CNRS UMR 5164, Bordeaux University, Bordeaux 33076, FranceCorrespondence: Amaury DasteDepartment of Medical Oncology, Hôpital Saint-André, CHU Bordeaux-University of Bordeaux, 1 Rue Jean Burguet, Bordeaux 33000, FranceFax +33 5 56 79 58 96Email [email protected]: Immune checkpoint inhibitors (ICIs) have radically changed the clinical outcome of several cancers with durable responses. CTLA-4 (cytotoxic T lymphocyte antigen-4), PD-1 (programmed cell death protein 1) or PDL-1 (programmed cell death ligand protein 1) represent ICIs that can be used as monotherapy or in combination with other agents. The toxicity p\rofiles of ICIs differ from the side effects of cytotoxic agents and come with new toxicities like immune-related adverse events. Typically, these toxicities occur in all organs. However, the main organs affected are the skin, digestive, hepatic, lungs, rheumatologic, and endocrine. Most of the immune toxicity that occurs is low grade but some more severe toxicities can occur that require a rapid diagnosis and appropriate treatment. The recognition of symptoms by physicians and patient is necessary to resolve them rapidly and adapt treatment to allow the toxicity to resolve.Keywords: immune check point inhibitor, toxicity, corticosteroids, immunosuppressive treatments
