Supportive care for new cancer therapies

Abstract

Purpose of reviewThe past decade has witnessed unprecedented delivery to the clinical arena of a range of novel, innovative, and effective targeted anticancer therapies. These include immunotherapies, most prominently immune checkpoint inhibitors, as well as agents that target growth factors and cancer-related mutations. Many of these new cancer therapies are, however, associated with an array of toxicities, necessitating insight and vigilance on the part of attending physicians to achieve high-quality supportive care alongside toxicity management. In this review, we consider some of the key supportive care issues in toxicity management. Recent findingsAlthough both supportive care and targeted therapies have brought significant benefits to cancer care, the management of novel cancer therapy toxicities is nevertheless often complex. This is due in large part to the fact that target organs differ widely, particularly in the case of checkpoint inhibitors, with minor dermatological disorders being most common, while others, such as pneumonitis, are more severe and potentially life threatening. Accordingly, efficient management of these immune-related adverse events requires collaboration between multiple medical specialists.

Oncologic emergencies and urgencies: A comprehensive review

“…The largest group of small‐molecule antineoplastics are kinase inhibitors, but additional targets include epigenetic regulatory proteins (eg, histone deacylase (HDAC) inhibitors), DNA damage‐repair enzymes (eg, poly‐[ADP‐ribose] polymerase inhibitors), and proteasomes. These agents can also cause cytopenias (eg, olaparib, niraparib, and, entrectinib), nausea, vomiting and diarrhea (eg, ribociclib, palbociclib, vemurafenib, and dabrafenib), and cardiomyopathy (eg, cobimetinib, trametinib, sunitinib, and pazopanib) 104,136 . Management of these complications parallels previously described algorithms.…”

“…These agents can also cause cytopenias (eg, olaparib, niraparib, and, entrectinib), nausea, vomiting and diarrhea (eg, ribociclib, palbociclib, vemurafenib, and dabrafenib), and cardiomyopathy (eg, cobimetinib, trametinib, sunitinib, and pazopanib). 104,136 Management of these complications parallels previously described algorithms. Cataloguing the specific toxicities associated with each approved small-molecule agent can be accessed in the reviews cited above.…”

Raising awareness of immune-related side effects in oncological patients under palliative care: a report of two cases

“…Since palliative treatment regimens are increasingly implemented nowadays, palliative patients are at high risk of developing late onset high grade irAEs more than six months after starting ICI treatment and need continuous follow-up care (8,20,21). Involving PC early on leads to better symptom control (22), timely end of life discussions and a reduction in readmissions to hospital which ameliorates the patients' overall quality of life (16)(17)(18)23).…”