Immun-Checkpoint-Inhibitoren: Management von Nebenwirkungen

Die PD1- und PD-L1-Inhibitoren verursachen im Vergleich zu einer klassischen Tumortherapie mit Zytostatika weniger Nebenwirkungen und insbesondere ganz andere Nebenwirkungen. Um die Patienten vor diesen Nebenwirkungen und den – in seltenen Fällen – auch lebensgefährlichen Folgen zu schützen, sind eine Reihe von Maßnahmen erforderlich.

• Literatur

• 1 Reck M, Rodríguez-Abreu D, Robinson A. et al. Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer. New Engl J Med 2016; 375: 1823-1833
• 2 Hao C, Tian JL, Liu H. et al. Efficacy and safety of anti-PD-1 and anti-PD-1 combined with anti-CTLA-4 immunotherapy to advanced melanoma. A systematic review and meta-analysis of randomized controlled trials. Medicine 2017; 96: e7325 . doi: 10.1097/MD.0000000000007325
• 3 Weber JS, Kähler KC, Hauschild A. Management of immune-related adverse events and kinetics of response with ipilimumab. J Clin Oncol 2012; 30: 2691-2697
• 4 Boutros C, Tarhini A, Routier E. et al. Safety profiles of anti-CTLA-4 and anti-PD-1 antibodies alone and in combination. Nature Rev Clin Oncol 2016; 13: 473-486
• 5 Wolchok JD, Chiarion-Sileni V, Gonzalez R. et al. Overall Survival with Combined Nivolumab and Ipilimumab in Advanced Melanoma. New Engl J Med 2017; 377: 1345-1356
• 6 Motzer RJ, Tannir NM, McDermott DF. et al. Nivolumab plus Ipilimumab versus Sunitinib in Advanced Renal-Cell Carcinoma. N Engl J Med 2018; 378: 1277-1290
• 7 Champiat S, Lambotte O, Barreau E. et al. Management of immune checkpoint blockade dysimmune toxicities. A collaborative position paper. Ann Oncol 2016; 27: 559-574
• 8 National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE). NIH Publication 2010; No. 09-5410.
• 9 Haanen JBAG, Carbonnel F, Robert C. et al. Management of toxicities from immunotherapy. ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2017; 28 (Suppl. 04) iv119-iv142
• 10 Haanen JBAG, Carbonnel F, Robert C. et al. Management of toxicities from immunotherapy. ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018; 29 (Suppl. 04) iv264-iv266
• 11 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.
• 12 Marthe L, Mateus C, Mussini C. et al. Cancer Immunotherapy with Anti-CTLA-4 Monoclonal Antibodies Induces an Inflammatory Bowel Disease. J Crohn's & colitis 2016; 10: 395-401
• 13 Gupta A, de Felice KM, Loftus EV. et al. Systematic review. Colitis associated with anti-CTLA-4 therapy. Aliment Pharmacol Therap 2015; 42: 406-417
• 14 Bergqvist V, Hertervig E, Gedeon P. et al. Vedolizumab treatment for immune checkpoint inhibitor-induced enterocolitis. Cancer Immunol Immunother 2017; 66: 581-592