Adverse Events of Oncologic Immunotherapy and Their Management

Abstract

Over the past two decades, immunotherapy has emerged as a promising treatment option for patients with cancer. However, newer versions of immunotherapy, such as checkpoint inhibitors, may be associated with unusual adverse effects (AEs) that can range in severity from mild to life-threatening. Unlike common AEs of conventional chemotherapy, which have a predictable nadir or cyclic pattern after administration, AEs of these newer immunotherapies are variable, depending on the type of immunotherapy, route of administration, and mechanism of action. The onset and resolution of these AEs may be present at any time, during administration of treatment, a few weeks after administration of treatment, or several months after completion of treatment. Therefore, improving outcomes in patients undergoing oncologic immunotherapy requires oncology nurses’ knowledge and understanding of various immunotherapy agents, as well as early recognition and management of potential AEs, especially AEs associated with checkpoint inhibitors and other therapies that manipulate T-cell activation causing autoimmune toxicity. This article draws upon current evidence from systematic reviews, meta-analyses, and expert consensus guidelines to provide a brief overview of common immunotherapies used in cancer and management of their associated AEs.

The Role of the Innate Immune System in Cancer Dormancy and Relapse

“…However, activating the immune system in patients recovering from debilitating diseases like cancer may be challenging. Side effects may range from milder symptoms, such as headaches and hypertension, to the establishment of life-threatening conditions like kidney necrosis and autoimmune toxicity that eventually compromises the functionality of otherwise healthy tissues [ 140 ].…”

Comparison of EQ-5D-3L with QLU-C10D in Metastatic Melanoma Using Cost-Utility Analysis

“…QLQ-C30 items are tailored to capture issues related to chemotherapies such as nausea/vomiting, constipation, appetite loss, and diarrhoea. Newer cancer treatments like immunotherapies have different adverse event profiles [31]. Common immune-related adverse events include colitis, pneumonitis, hypothyroidism, and inflammatory arthritis, [32] which are not explicitly captured by the QLQ-C30.…”

O Transtorno De Personalidade Narcisista E as Relações Afetivas: Uma Contribuição Da Psicanálise

“…Os anticorpos monoclonais têm um potencial para causar reações não alérgicas, resultantes da liberação de citocinas logo após a infusão e ocorrem, geralmente, na primeira dose. A incidência da reação varia de 77% com rituximabe a 15% com cetuximabe e diminui com cada curso subsequente de terapia (ROSELLÓ et al, 2017;BARBER, 2019). Os tipos de câncer mais descritos nos estudos foram os de pulmão, mama, colorretal, ovário, gástrico e linfomas e estão relacionados aos tipos de câncer mais incidentes tanto em países desenvolvidos, quanto em desenvolvimento, visto que há estudos revisados de ambos.…”