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:

Neurological7,9

Endocrine system

(hyperthyroidism, hypothyroidism, and hypophysitis)7

Gastrointestinal tract

(diarrhea and colitis)7

Kidneys

(nephritis)8

Liver

(hepatitis)7

Lungs

(pneumonitis)7

Skin7

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

SCAR, severe cutaneous adverse reactions; SJS, Stevens-Johnson syndrome; TENS, toxic epidermal necrolysis; DRESS, drug reaction with eosinophilia and systemic symptoms; DIHS, drug-induced hypersensitivity syndrome.

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. Brahmer JR, Lacchetti C, Schneider BJ, et al. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2018:JCO2017776385. 8. 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. 9. 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.