Enhancing Cancer Treatment: A Comprehensive Guide to Managing Side Effects of Immune Checkpoint Inhibitors
Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, improving survival rates and quality of life for many patients. However, these treatments can also cause immune-related adverse events (irAEs), which can affect any organ in the body and, in some cases, can be life-threatening. Early detection and appropriate management of these side effects are crucial for optimizing patient outcomes.
The paper proposes a set of essential laboratory and functional tests to improve the early detection and management of irAEs in cancer patients treated with ICIs. These recommendations, developed by a multidisciplinary team of experts, can help identify potential irAEs at an early stage, initiate appropriate interventions, and reduce the burden of frequent blood sampling during ICI treatment.
The recommendations cover a wide range of organ systems and include tests for liver function, endocrine functions, cardiac function, musculoskeletal function, kidney function, fluid and electrolyte balance, bone metabolism, bone marrow function, latent infections, coagulation and fibrinolysis, and gastrointestinal function. The paper emphasizes the importance of individualizing these tests based on each patient's specific needs and conditions.
Article Information
Multidisciplinary recommendations for essential baseline functional and laboratory tests to facilitate early diagnosis and management of immune-related adverse events among cancer patients
Published in Cancer Immunology, Immunotherapy. Berna C Özdemir et al.
Abstract
Immune checkpoint inhibitors (ICIs) have fundamentally changed the treatment landscape of various cancers. While ICI treatments result in improved survival, quality of life and are cost-effective, the majority of patients experience at least one immune-related adverse event (irAE). Many of these side effects cause little discomfort or are asymptomatic; however, irAEs can affect any organ and are potentially life-threatening. Consequently, early diagnosis and appropriate treatment of irAEs are critical for optimizing long-term outcomes and quality of life in affected patients. Some irAEs are diagnosed according to typical symptoms, others by abnormal findings from diagnostic tests. While there are various guidelines addressing the management of irAEs, recommendations for the early recognition of irAEs as well as the optimal extent and frequency of laboratory tests are mostly lacking. In clinical practice, blood sampling is usually performed before each ICI administration (i.e., every 2-3 weeks), often for several months, representing a burden for patients as well as health care systems. In this report, we propose essential laboratory and functional tests to improve the early detection and management of irAEs and in cancer patients treated with ICIs. These multidisciplinary expert recommendations regarding essential laboratory and functional tests can be used to identify possible irAEs at an early time point, initiate appropriate interventions to improve patient outcomes, and reduce the burden of blood sampling during ICI treatment.
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