Managing immune checkpoint-blocking antibody side effects Journal Article

Author: Postow, M. A.
Article Title: Managing immune checkpoint-blocking antibody side effects
Abstract: Immune checkpoint-blocking antibodies that enhance the immune system's ability to fight cancer are becoming important components of treatment for patients with a variety of malignancies. Cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) was the first immune checkpoint to be clinically targeted, and ipilimumab, an inhibitor of CTLA-4, was approved by the U.S. Food and Drug Administration (FDA) for patients with advanced melanoma. The programmed cell death-1 (PD-1) receptor and one of its ligands, PD-L1, more recently have shown great promise as therapeutic targets in a variety of malignancies. Nivolumab and pembrolizumab recently have been FDA- approved for patients with melanoma and additional approvals within this therapeutic class are expected. The use of anti-CTLA-4 and anti-PD-1/PD-L1 antibodies is associated with side effects known as immune-related adverse events (irAEs). Immune-related adverse events affect the dermatologic, gastrointestinal, hepatic, endocrine, and other organ systems. Temporary immunosuppression with corticosteroids, tumor necrosis factor-alpha antagonists, mycophenolate mofetil, or other agents can be effective treatment. This article describes the side-effect profile of the checkpoint-blocking antibodies that target CTLA-4 and PD-1/PD-L1 and provides suggestions on how to manage specific irAEs.
Keywords: diarrhea; antineoplastic agents; antineoplastic agent; granulocyte macrophage colony stimulating factor; monoclonal antibody; immunology; antibodies, monoclonal; recombinant proteins; recombinant protein; colitis; cytotoxic t lymphocyte antigen 4; opportunistic infections; programmed death 1 receptor; drug-induced liver injury; granulocyte-macrophage colony-stimulating factor; ctla-4 antigen; humans; human; antagonists and inhibitors; programmed cell death 1 receptor; chemically induced; sargramostim
Journal Title: American Society of Clinical Oncology Educational Book
Volume: 35
ISSN: 1548-8756
Publisher: American Society of Clinical Oncology  
Date Published: 2015-01-01
Start Page: 76
End Page: 83
Language: English
DOI: 10.14694/EdBook_AM.2015.35.76
PUBMED: 25993145
PROVIDER: scopus
Notes: Review -- Export Date: 25 January 2017 -- Source: Scopus
Citation Impact
MSK Authors
  1. Michael Andrew Postow
    288 Postow