Adverse effects
Immune checkpoint blockade can induce significant antitumor benefits
but
checkpoint blockade does not just enhance tumor specific immune responses, unique adverse effects can occur through nonspecific immunologic
activation.
检查点阻断不只是增强肿瘤特异性免疫反应,独特的不良反应可以通过非特异性免疫发生激活。
Adverse effects from these agents have been termed „immune related adverse events (irAEs)
Kinetics of Appearance of irAEs With Checkpoint Blockade
/ Data from pts receiving anti-PD-1 antibodies q2w for > 3 yrs show most irAEs occur by Wk 24 (6 mos)
/ Toxicities with PD-1/PD-L1 agents may take longer to resolve than with ipilimumab, so long-term surveillance is recommended
Management of Drug-Related AEs
/ The majority of both Anti CTLA 4 and anti PD 1- related AEs to date have been reversible and manageable by delaying study drug ± administration of corticosteroids; other immunosuppressants may also be needed
/ The following categories of AEs, requiring greater vigilance and early intervention:
/ Pulmonary
/ Hepatic
/ Renal
/ GI
/ Endocrine
/ Neurological
/ Skin
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