HelixTalk Episode #111 - The Basics of Immune Checkpoint Inhibitors for Non-Oncology Healthcare Providers

Date posted: April 7, 2020, 6:00 am

In this episode, we chat with Eris Tollkuci, PharmD, BCOP regarding what every non-onc healthcare provider should know about immune checkpoint inhibitors (specifically PD-1/PD-L1 inhibitors) in patients with cancer.

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Key Concepts

1. Immune checkpoint inhibitors (ICIs) are a new therapeutic class that are used for a variety of different cancers.  Clinicians will absolutely see these drugs being used in clinical practice.
2. Immune-related adverse effects are a unique toxicity of ICIs.  Patients and healthcare providers should be educated about monitoring for and identifying these adverse effects.
3. There are specific guidelines for treating immune-related adverse effects.  Depending on the tissue or organ involved, treatment can include continuing therapy, holding the ICI until the toxicity resolves, administration of corticosteroids, and permanent discontinuation of all future ICIs.
4. For many (but not all) immune-related adverse effects, corticosteroids are a common cornerstone of management.

References

• Hall KH, Liu Y, Jiang C, et al. New and Worsening Long-term Immune-Related Adverse Events with PD-1/PD-L1 Pathway Agents in Patients with Cancer. Pharmacotherapy. 2020 Feb;40(2):133-141. doi: 10.1002/phar.2354.
• Brahmer JR, Lacchetti C, Schneider BJ, et al. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2018 Jun 10;36(17):1714-1768. doi: 10.1200/JCO.2017.77.6385.
• de Filette JMK, Pen JJ, Decoster L, et al. Immune checkpoint inhibitors and type 1 diabetes mellitus: a case report and systematic review. Eur J Endocrinol. 2019 Sep;181(3):363-374. doi: 10.1530/EJE-19-0291.