Immune Related Adverse Events: Classification and Management Approaches in Advanced Kidney Cancer

Cancer J. 2020 Sep/Oct;26(5):432-440. doi: 10.1097/PPO.0000000000000473.

Abstract

Recent therapeutic advancements have incorporated immune checkpoint inhibitors (ICIs) into the management of metastatic renal cell carcinoma. Pivotal phase III trials have resulted in Food and Drug Administration approval for anti-programmed death 1/programmed death ligand 1 ICIs, either in combination with anti-cytotoxic T-lymphocyte antigen 4 ICIs or with vascular endothelial growth factor-directed targeted therapies, as standard-of-care frontline regimens. Immune checkpoint inhibitors offer improved clinical outcomes when compared to previous treatment options. However, these agents also present unique toxicity profiles collectively referred to as immune-related adverse events. Common immune-related adverse events include colitis, hepatitis, dermatitis, and thyroiditis. Rare toxicities, such as myocarditis and pneumonitis, have the potential for causing severe harm. Herein, we provide a case-based discussion of how to identify, grade, and manage irAEs in metastatic renal cell carcinoma.

Publication types

  • Review

MeSH terms

  • Carcinoma, Renal Cell* / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Kidney Neoplasms* / drug therapy
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors

Substances

  • Immune Checkpoint Inhibitors
  • Vascular Endothelial Growth Factor A