Monitoring and Management of Immune-Related Adverse Events Associated With Programmed Cell Death Protein-1 Axis Inhibitors in Lung Cancer

Grainne M O'Kane; Catherine Labbé; Mark K Doherty; Kelvin Young; Hamzeh Albaba; Natasha B Leighl

doi:10.1634/theoncologist.2016-0164

Monitoring and Management of Immune-Related Adverse Events Associated With Programmed Cell Death Protein-1 Axis Inhibitors in Lung Cancer

Oncologist. 2017 Jan;22(1):70-80. doi: 10.1634/theoncologist.2016-0164. Epub 2016 Aug 17.

Authors

Grainne M O'Kane¹, Catherine Labbé¹, Mark K Doherty¹, Kelvin Young¹, Hamzeh Albaba¹, Natasha B Leighl²

Affiliations

¹ Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
² Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada [email protected].

Abstract

Monoclonal antibodies targeting programmed cell death protein-1 (PD-1) represent a new treatment paradigm in non-small cell lung cancer. Three phase III trials have demonstrated a survival benefit and improved tolerability of nivolumab and pembrolizumab when compared with standard second-line chemotherapy. Nevertheless, the adverse events associated with PD-1 inhibitors are unique; early recognition and treatment are essential. This review summarizes the required monitoring and appropriate management of immune-related adverse events in lung cancer patients receiving these agents.

The oncologist: 2017;22:70-80 IMPLICATIONS FOR PRACTICE: : The potential adverse events of immune checkpoint inhibitors differ from conventional chemotherapy and can require a multidisciplinary approach. Continued education is important for all physicians to ensure optimal care for patients.

Keywords: Immune‐related adverse events; Immunotherapy; Lung cancer; Programmed cell death protein‐1; Programmed death ligand‐1; Toxicities.

Publication types

Review

MeSH terms

Antibodies, Monoclonal / adverse effects
Antibodies, Monoclonal / therapeutic use
Antibodies, Monoclonal, Humanized / adverse effects
Antibodies, Monoclonal, Humanized / therapeutic use
Antineoplastic Agents / adverse effects
Antineoplastic Agents / immunology
Antineoplastic Agents / therapeutic use
B7-H1 Antigen / antagonists & inhibitors
B7-H1 Antigen / genetics*
CTLA-4 Antigen / genetics
Drug-Related Side Effects and Adverse Reactions / classification
Drug-Related Side Effects and Adverse Reactions / immunology*
Drug-Related Side Effects and Adverse Reactions / pathology
Humans
Lung Neoplasms / drug therapy*
Lung Neoplasms / genetics
Lung Neoplasms / immunology
Lung Neoplasms / pathology
Molecular Targeted Therapy
Nivolumab
Programmed Cell Death 1 Receptor / antagonists & inhibitors
Programmed Cell Death 1 Receptor / genetics*
Signal Transduction / drug effects

Substances

Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Antineoplastic Agents
B7-H1 Antigen
CD274 protein, human
CTLA-4 Antigen
PDCD1 protein, human
Programmed Cell Death 1 Receptor
Nivolumab
pembrolizumab