Although immune checkpoint therapy can induce significant antitumor benefits due to immune enhancing, unique adverse effects can occur through nonspecific immunologic activation. Although adverse effects for immune checkpoint therapy are different in character from adverse events caused by traditional chemotherapy or targeted therapy, the rate of grade 3 or 4 toxicity with immune checkpoint blockade (approximately 10% to 20%) is no greater than that seen with many standard chemotherapy or targeted therapy regimen.
Adverse effects for immune checkpoint therapy in cancer include dermatologic,GI, hepatic,endocrine, other less common inflammatory events.
Because adverse effects arise from general immunologic enhancement, temporary immunosuppression with corticosteroids, tumor necrosis factor α antagonists, mycophenolate mofetil, or other agents is often necessary and should follow immune checkpoint therapy in cancer. Recommendations for adverse effects come from general clinical consensus because no prospective trials have been conducted to specifically test whether one management strategy is superior.
Michael A. Postow et al. Immune Checkpoint Blockade in Cancer Therapy. American Society of Clinical Oncology. 2015, 33(17):1974-1982.
Howard (Jack) West, MD et al. Immune Checkpoint Inhibitors. JAMA Oncol. 2015;1(1):115.
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