Nebenwirkungsmanagement von Immuncheckpoint-Inhibitor-Therapien

Immuncheckpoint-Inhibitoren sind für die Behandlung von Patienten mit verschiedenen Krebsentitäten mittlerweile zur klinischen Routine geworden. Dies bedeutet auch, dass immunvermittelte Nebenwirkungen fester Bestandteil des klinischen Alltags geworden sind. Dieser Artikel gibt eine Übersicht über immunvermittelte Nebenwirkungen und zeigt eine allgemeine Herangehensweise an den Umgang mit diesen Toxizitäten.

Abstract

Immunotherapy with checkpoint inhibitors – monoclonal antibodies targeting cytotoxic T lymphocyte-associated antigen 4 (CTLA4) or the programmed death-1 receptor (PD-1) and its ligand PD-L1 – is now standard of care in the treatment of patients with various tumor types. Therefore, the management of immune-related adverse events (irAEs) has become part of clinical routine.

Immune-related adverse events can involve any organ or tissue. They can occur very early within days or weeks after initiation of treatment but can also occur months into treatment and after termination of treatment. Newest data suggest that irAEs can occur until 2 years after stopping therapy.

Immune-related adverse events are graded according to Common Terminology Criteria for Adverse Events (CTCAE). Treatment ranges from local or symptomatic treatment, systemic application of corticosteroids to other immunosuppressive agents according to severity.

The following article seeks to give a general approach to the management of patients receiving immunotherapy and experiencing irAEs including prevention, diagnostics and treatment.

Schlüsselwörter

Immuntherapie - immunvermittelte Nebenwirkungen - Immuncheckpoint-Inhibitoren

Key words

immunotherapy - immune-related adverse events (irAEs) - checkpoint inhibitors

Publication History

Article published online:
26 August 2021

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