[Immune-related adverse events by immune checkpoint inhibitors]

Nihon Rinsho Meneki Gakkai Kaishi. 2017;40(2):83-89. doi: 10.2177/jsci.40.83.
[Article in Japanese]

Abstract

Recent introduction of immune checkpoint inhibitors represented by anti-PD-1 antibodies such as nivolumab and pembrolizumab, and anti-CTLA-4 antibody such as ipilimumab had a great impact on cancer immunotherapy especially for melanoma, non-small cell lung cancer, renal cell carcinoma, and Hodgkin's lymphoma. On the other hand, immune checkpoint inhibitors have their own distinctive adverse events, which are collectively named as "immune-related adverse events". Although immune-related adverse events may occur at any part of the body, interstitial pneumonia, colitis, hypothyroidism, liver dysfunction, skin rash, vitiligo, hypophysitis, type 1 diabetes, renal dysfunction, myasthenia gravis, neuropathy, myositis, and uveitis are representative. The onset of these immune-related adverse events varies. As for ipilimumab, cutaneous and mucous complications appear relatively early, and subsequently digestive symptoms emerge. As for nivolumab, most immune-related adverse events start around a few months after its administration. These immune-related adverse events are basically managed according to the algorism. Prompt consultation to the experts are of great importance and the grade of immune-related adverse events and patients' disease conditions need to be carefully evaluated to decide the optimal measures. As immune-related adverse events could affect various organs, cooperation with many experts from various fields is critical and it is important to organize a cooperative system within a hospital.

Keywords: immune checkpoint inhibitor; immune-related adverse event; ipilimumab; nivolumab; vitiligo.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • CTLA-4 Antigen / immunology
  • Chemical and Drug Induced Liver Injury / etiology
  • Chemical and Drug Induced Liver Injury / therapy
  • Colitis / chemically induced
  • Colitis / therapy
  • Humans
  • Hypothyroidism / chemically induced
  • Hypothyroidism / therapy
  • Interdisciplinary Communication
  • Ipilimumab
  • Lung Diseases, Interstitial / chemically induced
  • Lung Diseases, Interstitial / therapy
  • Neoplasms / drug therapy
  • Nivolumab
  • Patient Care Team
  • Programmed Cell Death 1 Receptor / immunology
  • Vitiligo / chemically induced
  • Vitiligo / therapy

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • CTLA-4 Antigen
  • Ipilimumab
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor
  • Nivolumab
  • pembrolizumab