Immunotherapy Toxicities

Surg Oncol Clin N Am. 2019 Jul;28(3):387-401. doi: 10.1016/j.soc.2019.02.009. Epub 2019 Apr 5.

Abstract

Immune checkpoint inhibitors (ICIs) are therapeutic antibodies that target regulatory molecules on T cells and represent the most widely used FDA-approved class of immunotherapy. ICIs are associated with unique immune-mediated toxicities called immune-related adverse events. These toxicities may affect any organ system, and their precise mechanisms of action remain under investigation. Current evidence suggests that activation of T cells is involved, although other components of the immune response have been implicated. This article summarizes toxicities, potential mechanisms of action, management strategies, and other clinical considerations. Unique mechanisms of action and immune-related toxicities of other FDA-approved classes of immunotherapy are reviewed.

Keywords: Immune checkpoint inhibitors side effects; Immune-related adverse events (irAE); Mechanisms of irAE; T cell mediated toxicity.

Publication types

  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents, Immunological / adverse effects*
  • Cell Cycle Checkpoints / drug effects*
  • Drug-Related Side Effects and Adverse Reactions / etiology*
  • Drug-Related Side Effects and Adverse Reactions / prevention & control
  • Humans
  • Immunotherapy / adverse effects*
  • Neoplasms / drug therapy*
  • Neoplasms / immunology
  • Risk Factors

Substances

  • Antineoplastic Agents, Immunological