2020 Clinical Practice Recommendations for the Management of Immune-mediated Adverse Events from Checkpoint Inhibitors

2020    MASCC presents a collection of 2020 clinical practice recommendations for the management of immune-mediated adverse events from checkpoint inhibitors. These recommendations are focused on patients with the most severe toxicities and provide an important international resource and reference in helping improve the management of these presentations.

Immune checkpoint inhibitors (ICIs) have emerged as the newest pillar of cancer treatment transforming outcomes in melanoma and showing benefit in a range of malignancies. ICIs include those targeting programmed death-1 and its ligand (PD-1 and PD-L1) and cytotoxic T lymphocyte antigen-4 (CTLA-4). Combinations of anti-PD-1/PD-L1 with anti-CTLA-4 augment immune responses and enhance clinical activity but increase the risk of toxicities. 

Immune-mediated toxicities, stemming from increased activity within the T cell lineage, range from asymptomatic or mild complications to those that are fulminant and potentially fatal. They can affect virtually any organ system. Recognition and management of these toxicities is an important challenge in current Oncology care. 

MASCC established the MASCC Subgroup on Immuno-Oncology (IO) in 2018 under the auspices of the Neutropenia, Infection, and Myelosuppression Study Group (SG). The IO subgroup comprises members from numerous medical specialties with an interest in IrAEs. Represented disciplines include, but are not limited to, gastroenterology, dermatology, neurology, immunology, hematology, rheumatology, endocrinology, nephrology, and emergency medicine. 

MASCC appointed a multidisciplinary team of experts from different parts of the world including North America, South America, the UK, and South Africa and to develop these recommendations. In line with MASCC as a multidisciplinary professional association, the team was comprised of basic scientists and clinical investigators, including medical oncologists, emergency physicians, internal medicine sub-specialists, and specialist nurses. 

Click here to read the entire collection link of recommendations, featured in a special edition in the journal of Supportive Care in Cancer.

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