Emergency care in oncology: potential complications of treatment with immune checkpoint inhibitors

DOI: https://dx.doi.org/10.18565/pharmateca.2019.12.92-99

R.I. Nuriev (1, 2), M.I. Sekacheva (1), A.P. Bondarenko (2), M.P. Baranova (2, 3), S.Yu. Sletina (2), E.V. Poddubskaya (1, 2)

1) Sechenov First Moscow State Medical University, Moscow, Russia; 2) Clinical Center Vitamed, Moscow, Russia; 3) Department of Oncology, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
Immune checkpoint inhibitors aimed to blocking the cytotoxic T-lymphocyte associated protein 4 (CTLA-4) and programmed cell death protein 1 (PD-1) or its ligand PD-L1, show a high potential for antitumor activity in many oncological diseases including melanoma, non-small cell lung cancer, renal cell carcinoma, and urothelial carcinoma. Some of these drugs are already becoming the main line of therapy for the late stages of melanoma and other malignant neoplasms. Immune checkpoint inhibitors, however, have a particular profile of side effects, causing immune-mediated adverse events (IMAEs). These side effects can occur in any organ system, but the most common are lesions of the skin, gastrointestinal tract, endocrine and respiratory systems. IMAEs are usually treated with glucocorticosteroids which suppress the excessive activity of the immune response. Doctors of any specialties should know this class of drugs and their AE profile in order to recognize patients with IMAEs in time and prescribe the necessary therapy. This article provides a short description of the main immune checkpoints inhibitors and discusses the most common AEs that doctors may encounter in their practice.
Keywords: immune checkpoint inhibitors, CTLA-4, PD-1, PD-L1, immune-mediated adverse events, immunotherapy, emergency therapy

About the Autors

Corresponding author: Elena V. Poddubskaya, PhD, Deputy Director of the Clinical Center of Sechenov University for Oncology, Sechenov First Moscow State Medical University, Moscow, Russia; e-mail: podd-elena@yandex.ru
Address: 8, Trubetskaya Street, Moscow 119991, Russian Federation

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