Immune-Mediated Adverse Events

Diagnosing and Managing imAEs

Watch expert points of view on managing imAEs

Monitor

Tracking imAEs

imAEs can be different from side effects expected with chemotherapy. It’s important to understand the safety profile of the specific treatment and encourage your patients to track any symptoms they may experience.4-6

While imAEs can affect any organ or tissue, the most commonly affected areas are2,3:

Neurological7

Endocrine system

(hyperthyroidism, hypothyroidism, and hypophysitis)8

Gastrointestinal tract

(diarrhea and colitis)8

Kidneys

(nephritis)8

Liver

(hepatitis)9

Lungs

(pneumonitis)8

Skin10

Monitor your patients’ health3,5,6:

Manage

Proactive management of imAEs

Early recognition and monitoring of all imAEs can help manage adverse events before they become more serious and cause treatment interruption.6

Create an action plan2,3

Follow a clear management algorithm for all grades of toxicities

Understand when a specialist should be contacted to help manage imAEs

Intervene when necessary6

Consult applicable product label for specific recommendations. In general, the management of imAEs may include the use of corticosteroids or other immunosuppressive agents.4,6

Watch the videos below to learn more about the diagnosis and treatment of imAEs related to the most commonly affected organs.

Expert points of view

Hear from thought leaders in oncology on the diagnosis and management of imAEs.

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imAEs: Introduction

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Chapters: 3

Total Time: 01:44

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imAEs: Endocrine system

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Chapters: 5

Total Time: 07:28

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imAEs: Gastrointestinal tract

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Chapters: 6

Total Time: 06:33

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imAEs: Kidneys

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Chapters: 6

Total Time: 05:26

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imAEs: Liver

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Chapters: 6

Total Time: 04:38

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imAEs: Lungs

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Chapters: 5

Total Time: 04:03

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imAEs: Skin

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Chapters: 8

Total Time: 07:50

References

1. Gangadhar TC, Vonderheide RH. Mitigating the toxic effects of anticancer immunotherapy. Nat Rev Clin Oncol. 2014;11:91-99. 2. Nishijima TF, Shachar SS, Nyrop KA, Muss HB. Safety and tolerability of PD-1/PD-L1 inhibitors compared with chemotherapy in patients with advanced cancer: a meta-analysis. Oncologist. 2017;22:1-10. 3. Spain L, Diem S, Larkin J. Complications of treatment: management of toxicities of immune checkpoint inhibitors. Cancer Treat Rev. 2016;44:51-60. 4. Postow MA, Callahan MK, Wolchok JD. Immune checkpoint blockade in cancer therapy. J Clin Oncol. 2015;33(17):1974-1982. 5. Weber JS, Yang JC, Atkins MB, Disis ML. Toxicities of immunotherapy for the practitioner. J Clin Oncol. 2015;33(18):2092-2099. 6. Kumar V, Chaudhary N, Garg M, Floudas CS, Soni P, Chandra AB. Current diagnosis and management of immune related adverse events (irAEs) induced by immune checkpoint inhibitor therapy. Front Pharmacol. 2017;8:1-14. doi:10.3389/ fphar.2017.00049. 7. Voskens CJ, Goldinger SM, Loquai C, et al. The price of tumor control: an analysis of rare side effects of anti-CTLA-4 therapy in metastatic melanoma from the ipilimumab network. PLoS ONE. 2013;8(1):e53745. doi:10.1371/ journal.pone.0053745. 8. Eigentler TK, Hassel JC, Berking C, et al. Diagnosis, monitoring and management of immune-related adverse drug reactions of anti-PD-1 antibody therapy. Cancer Treat Rev. 2016;45:7-18. doi: 10.1016/j.ctrv.2016.02.003. 9. Weber JS, Kähler KC, Hauschild A. Management of immune-related adverse events and kinetics of response with ipilimumab. J Clin Oncol. 2012;30(21):2691-2697. 10. Friedman CF, Proverbs-Singh. TA, Postow MA. Treatment of the immune-related adverse effects of immune checkpoint inhibitors. JAMA Oncol. 2016;2(10):1346-1353.