New therapeutic perspectives to manage refractory immune checkpoint-related toxicities.

Details

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State: Public
Version: Author's accepted manuscript
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_42DB9145A8A7
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
New therapeutic perspectives to manage refractory immune checkpoint-related toxicities.
Journal
The Lancet. Oncology
Author(s)
Martins F., Sykiotis G.P., Maillard M., Fraga M., Ribi C., Kuntzer T., Michielin O., Peters S., Coukos G., Spertini F., Thompson J.A., Obeid M.
ISSN
1474-5488 (Electronic)
ISSN-L
1470-2045
Publication state
Published
Issued date
01/2019
Peer-reviewed
Oui
Volume
20
Number
1
Pages
e54-e64
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Immune checkpoint inhibitors are reshaping the prognosis of many cancer and are progressively becoming the standard of care in the treatment of many tumour types. Immunotherapy is bringing new hope to patients, but also a whole new spectrum of toxicities for healthcare practitioners to manage. Oncologists and specialists involved in the pluridisciplinary management of patients with cancer are increasingly confronted with the therapeutic challenge of treating patients with severe and refractory immune-related adverse events. In this Personal View, we summarise the therapeutic strategies that have been used to manage such toxicities resulting from immune checkpoint inhibitor treatment. On the basis of current knowledge about their pathogenesis, we discuss the use of new biological and non-biological immunosuppressive drugs to treat severe and steroid refractory immune-related adverse events. Depending on the immune infiltrate type that is predominant, we propose a treatment algorithm for personalised management that goes beyond typical corticosteroid use. We propose a so-called shut-off strategy that aims at inhibiting key inflammatory components involved in the pathophysiological processes of immune-related adverse events, and limits potential adverse effects of drug immunosuppression on tumour response. This approach develops on current guidelines and challenges the step-by-step increase approach to drug immunosuppression.
Keywords
Algorithms, Antibodies, Monoclonal/adverse effects, Antineoplastic Agents/adverse effects, Drug-Related Side Effects and Adverse Reactions/drug therapy, Drug-Related Side Effects and Adverse Reactions/immunology, Drug-Related Side Effects and Adverse Reactions/pathology, Drug-Related Side Effects and Adverse Reactions/physiopathology, Humans, Immunosuppressive Agents/adverse effects, Immunosuppressive Agents/therapeutic use, Immunotherapy/adverse effects, Neoplasms/therapy, Precision Medicine
Pubmed
Web of science
Open Access
Yes
Create date
11/01/2019 12:06
Last modification date
27/04/2020 5:20
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