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Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update

Schneider, Bryan J ; Naidoo, Jarushka ; Santomasso, Bianca D ; Lacchetti, Christina ; Adkins, Sherry ; Anadkat, Milan ; Atkins, Michael B ; Brassil, Kelly J ; Caterino, Jeffrey M ; Chau, Ian ; Davies, Marianne J ; Ernstoff, Marc S ; Fecher, Leslie ; Ghosh, Monalisa ; Jaiyesimi, Ishmael ; Mammen, Jennifer S ; Naing, Aung ; Nastoupil, Loretta J ; Phillips, Tanyanika ; Porter, Laura D ; Reichner, Cristina A ; Seigel, Carole ; Song, Jung-Min ; Spira, Alexander ; Suarez-Almazor, Maria ; Swami, Umang ; Thompson, John A ; Vikas, Praveen ; Wang, Yinghong ; Weber, Jeffrey S ; Funchain, Pauline ; Bollin, Kathryn

Journal of clinical oncology, 2021-12, Vol.39 (36), p.4073-4126 [Periódico revisado por pares]

United States

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Título:
Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update
Autor: Schneider, Bryan J ; Naidoo, Jarushka ; Santomasso, Bianca D ; Lacchetti, Christina ; Adkins, Sherry ; Anadkat, Milan ; Atkins, Michael B ; Brassil, Kelly J ; Caterino, Jeffrey M ; Chau, Ian ; Davies, Marianne J ; Ernstoff, Marc S ; Fecher, Leslie ; Ghosh, Monalisa ; Jaiyesimi, Ishmael ; Mammen, Jennifer S ; Naing, Aung ; Nastoupil, Loretta J ; Phillips, Tanyanika ; Porter, Laura D ; Reichner, Cristina A ; Seigel, Carole ; Song, Jung-Min ; Spira, Alexander ; Suarez-Almazor, Maria ; Swami, Umang ; Thompson, John A ; Vikas, Praveen ; Wang, Yinghong ; Weber, Jeffrey S ; Funchain, Pauline ; Bollin, Kathryn
Assuntos: Humans ; Immune Checkpoint Inhibitors - adverse effects
É parte de: Journal of clinical oncology, 2021-12, Vol.39 (36), p.4073-4126
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Instructional Material/Guideline-1
ObjectType-Feature-3
content type line 23
Descrição: To increase awareness, outline strategies, and offer guidance on the recommended management of immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitor (ICPi) therapy. A multidisciplinary panel of medical oncology, dermatology, gastroenterology, rheumatology, pulmonology, endocrinology, neurology, hematology, emergency medicine, nursing, trialists, and advocacy experts was convened to update the guideline. Guideline development involved a systematic literature review and an informal consensus process. The systematic review focused on evidence published from 2017 through 2021. A total of 175 studies met the eligibility criteria of the systematic review and were pertinent to the development of the recommendations. Because of the paucity of high-quality evidence, recommendations are based on expert consensus. Recommendations for specific organ system-based toxicity diagnosis and management are presented. While management varies according to the organ system affected, in general, ICPi therapy should be continued with close monitoring for grade 1 toxicities, except for some neurologic, hematologic, and cardiac toxicities. ICPi therapy may be suspended for most grade 2 toxicities, with consideration of resuming when symptoms revert ≤ grade 1. Corticosteroids may be administered. Grade 3 toxicities generally warrant suspension of ICPis and the initiation of high-dose corticosteroids. Corticosteroids should be tapered over the course of at least 4-6 weeks. Some refractory cases may require other immunosuppressive therapy. In general, permanent discontinuation of ICPis is recommended with grade 4 toxicities, except for endocrinopathies that have been controlled by hormone replacement. Additional information is available at www.asco.org/supportive-care-guidelines.
Editor: United States
Idioma: Inglês

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Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update

United States

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