Concomitant use of corticosteroids and immune checkpoint inhibitors in patients with hematologic or solid neoplasms: A systematic review

Garant, Aurélie; Guilbault, Claudine; Ekmekjian, Taline; Greenwald, Zoë R; Murgoi, P.; Vuong, T.

doi:10.1016/j.critrevonc.2017.10.009

Cited by 89 publications

(65 citation statements)

References 34 publications

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“…corticosteroids for IRAEs following ICPI therapy. 21 While the proportion of patients receiving corticosteroids for IRAEs varied slightly between the studies, corticosteroids were generally prescribed for around one-third of patients, comparable to the results observed in this audit. 21,22 Glucocorticoid use after checkpoint inhibitors…”

Section: Hyperglycaemiasupporting

confidence: 76%

Glucocorticoid use and complications following immune checkpoint inhibitor use in melanoma

2020

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Background Immune checkpoint inhibitors have demonstrated benefi t in the treatment of cancer, but are associated with toxicities, which often require treatment with glucocorticoids. Aims We aimed to determine the prevalence of glucocorticoid use in patients treated with immune checkpoint inhibitors for melanoma in a single centre. Methods We performed a retrospective review of patients with advanced melanoma treated with an immune checkpoint inhibitor between September 2010 and January 2017. Patients treated with glucocorticoids had a cumulative dose and duration of glucocorticoid treatment calculated. New onset hyperglycaemia was also identifi ed. Results Of 412 patients receiving immune checkpoint therapy, 157 (38%) required glucocorticoids to treat toxicities. The median cumulative glucocorticoid dose was 2,795 mg (prednisolone equivalent) with a median duration of 61 days. Twenty-seven patients receiving glucocorticoids were noted to develop new onset hyperglycaemia. Conclusions Immune-related adverse events frequently occur in patients treated with immune checkpoint inhibitors. Consequently, patients receive prolonged courses of glucocorticoids. Awareness of glucocorticoid-induced side effects is required.

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Section: Hyperglycaemiasupporting

confidence: 76%

Glucocorticoid use and complications following immune checkpoint inhibitor use in melanoma

2020

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“…Whether concurrent steroid treatment counteracts the efficacy of CPIs in non-transplanted patients is still an issue of debate, a recent survey suggests that concomitant use of steroids does not necessarily influence the efficacy of CPI treatment. 16 In addition, immunosuppression did not prevent response in four patients (cases 1, 3, 8, and 13, Table 1) and a report has recently shown that preventive treatment with high-dose steroids, intended to avoid CPI-mediated rejection, did not prevent a remarkable response in a kidney transplant recipient. 6 Therefore, although reduction of immunosuppression to sub-therapeutic doses was not associated with organ rejection, 7,10,17 pre-treatment with steroids could be attempted in the absence of contraindications and immunosuppression tapered during the course of treatment whenever possible.…”

Section: Immunosuppressionmentioning

confidence: 87%

Use of checkpoint inhibitors in liver transplant recipients

Munker

Toni

2018

UEG Journal

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In spite of their major impact in cancer therapy, immune checkpoint inhibitors are considered to be contraindicated in liver transplant recipients due to fear of rejection and fatal liver failure. Nevertheless, an increasing number of instances of liver transplant recipients treated with checkpoint inhibitors is being published. We reviewed the reports on 14 known cases of liver transplant recipients who underwent treatment with checkpoint inhibitors and discuss factors likely to determine susceptibility to organ rejection including the choice of the agent and the immunosuppression employed, the assessment of Programmed cell death 1 ligand 1 (PD-L1) status in liver graft biopsies, and the time of treatment initiation.

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“…Our approach to such patients is outlined in detail in Table . Although there is the theoretical concern for reduced efficacy of immunotherapy with concomitant administration of immunosuppressive medications, the available evidence is limited and mixed . As no definitive conclusions can be drawn from existing data regarding cancer outcomes in patients treated with high‐dose systemic steroids, we recommend symptomatic treatment of high‐grade cutaneous toxicity with systemic immunosuppression.…”

Section: Discussionmentioning

confidence: 99%

A Case of Nivolumab-Induced Bullous Pemphigoid: Review of Dermatologic Toxicity Associated with Programmed Cell Death Protein-1/Programmed Death Ligand-1 Inhibitors and Recommendations for Diagnosis and Management

López

Geskin

2018

The Oncologist

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Bullous pemphigoid is an autoimmune subepidermal blistering disease characterized by the development of tense bullae and is most frequently seen in the elderly. PD‐1/PD‐L1‐induced bullous pemphigoid (BP) has emerged as a potentially serious dermatologic toxicity. This article reports a case of a 72‐year‐old woman who developed BP shortly after initiating treatment with the PD‐1 inhibitor nivolumab for metastatic non‐small cell lung cancer.

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Concomitant use of corticosteroids and immune checkpoint inhibitors in patients with hematologic or solid neoplasms: A systematic review

Cited by 89 publications

References 34 publications

Glucocorticoid use and complications following immune checkpoint inhibitor use in melanoma

Glucocorticoid use and complications following immune checkpoint inhibitor use in melanoma

Use of checkpoint inhibitors in liver transplant recipients

A Case of Nivolumab-Induced Bullous Pemphigoid: Review of Dermatologic Toxicity Associated with Programmed Cell Death Protein-1/Programmed Death Ligand-1 Inhibitors and Recommendations for Diagnosis and Management

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