Journal ArticleDOI
Severe Neurological Toxicity of Immune Checkpoint Inhibitors: Growing Spectrum.
Divyanshu Dubey,Divyanshu Dubey,Divyanshu Dubey,William S. David,Kerry L. Reynolds,Donald F. Chute,Nathan F. Clement,Justine V. Cohen,Donald P. Lawrence,Meghan J. Mooradian,Ryan J. Sullivan,Amanda C. Guidon +11 more
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TLDR
The real‐world frequency, phenotypes, co‐occurring immune‐related adverse events (irAEs), and long‐term outcomes of severe, grade III to V irAE‐N at a tertiary care center over 6 years are evaluated.Abstract:
Expanding use of immune-checkpoint inhibitors (ICIs) underscores the importance of accurate diagnosis and timely management of neurological immune-related adverse events (irAE-N). We evaluate the real-world frequency, phenotypes, co-occurring immune-related adverse events (irAEs), and long-term outcomes of severe, grade III to V irAE-N at a tertiary care center over 6 years. We analyze how our experience supports published literature and professional society guidelines. We also discuss these data with regard to common clinical scenarios, such as combination therapy, ICI rechallenge and risk of relapse of irAE-N, and corticosteroid taper, which are not specifically addressed by current guidelines and/or have limited data. Recommendations for management and future irAE-N reporting are outlined. ANN NEUROL 2020;87:659-669.read more
Citations
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Journal ArticleDOI
Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update.
Bryan J. Schneider,Jarushka Naidoo,Bianca Santomasso,Christina Lacchetti,Sherry Adkins,Milan J. Anadkat,Michael B. Atkins,Kelly J. Brassil,Jeffrey M. Caterino,Ian Chau,Marianne Davies,M. S. Ernstoff,Leslie A. Fecher,Monalisa Ghosh,Ishmael Jaiyesimi,Jennifer S. Mammen,Aung Naing,Loretta J. Nastoupil,Tanyanika Phillips,Laura Diane Porter,Cristina A. Reichner,Carole Seigel,Jung-Min Song,Alexander I. Spira,Maria E. Suarez-Almazor,Umang Swami,John A. Thompson,Praveen Vikas,Yinghong Wang,Jeffrey S. Weber,Pauline Funchain,Kathryn Bollin +31 more
TL;DR: In this article, the recommended management of immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitor (ICP) was discussed. But, the authors did not provide guidance on recommended management.
Journal ArticleDOI
Society for immunotherapy of cancer (sitc) clinical practice guideline on immune checkpoint inhibitor-related adverse events
Julie R. Brahmer,Hamzah Abu-Sbeih,Paolo A. Ascierto,Jill Brufsky,Laura C. Cappelli,Frank B. Cortazar,David E. Gerber,Lamya Hamad,Eric Hansen,Douglas B. Johnson,Mario E. Lacouture,Gregory A. Masters,Jarushka Naidoo,Jarushka Naidoo,Michele Nanni,Miguel-Angel Perales,Igor Puzanov,Bianca Santomasso,Satish Shanbhag,Rajeev Sharma,Dimitra Skondra,Jeffrey A. Sosman,Michelle Turner,M. S. Ernstoff +23 more
TL;DR: In this paper, the authors presented evidence-and consensus-based guidelines for the management of immune-related adverse events (irAEs) during ICI treatment, which were developed by the Society for Immunotherapy of Cancer (SITC).
Journal ArticleDOI
International Consensus Guidance for Management of Myasthenia Gravis: 2020 Update
Pushpa Narayanaswami,Donald B. Sanders,Gil I. Wolfe,Michael Benatar,Gabriel Cea,Amelia Evoli,Nils Erik Gilhus,Isabel Illa,Nancy L. Kuntz,Janice M. Massey,Arthur Melms,Hiroyuki Murai,Michael W. Nicolle,Jacqueline A. Palace,David P. Richman,J. Verschuuren +15 more
TL;DR: The 2016 formal consensus-based guidance for the management of myasthenia gravis based on the latest evidence in the literature is updated, based on new evidence, and provides recommendations to clinicians caring for patients with MG worldwide.
Journal ArticleDOI
Neurologic Adverse Events of Immune Checkpoint Inhibitors: A Systematic Review.
Alessandro Marini,Alessandro Marini,Andrea Bernardini,Gian Luigi Gigli,Mariarosaria Valente,Mariarosaria Valente,Sergio Muñiz-Castrillo,Sergio Muñiz-Castrillo,Jérôme Honnorat,Jérôme Honnorat,Alberto Vogrig +10 more
TL;DR: The most common n-irAEs reports were myositis (136/428, 32%), Guillain-Barre syndrome and other peripheral neuropathies (94/428 and 22%), myasthenic syndromes (58/ 428, 14%), encephalitis (56/684, 13%), cranial neuropathia (31/428), 7%), meningitis (13/684), 3%), CNS demyelinating diseases (8/428 2%), and myelitis (7/684 2%) as discussed by the authors.
Journal ArticleDOI
Consensus disease definitions for neurologic immune-related adverse events of immune checkpoint inhibitors.
Amanda C. Guidon,Leeann B Burton,Bart K Chwalisz,James M. Hillis,Teilo H Schaller,Anthony A. Amato,Allison Betof Warner,Priscilla K. Brastianos,Tracey A. Cho,Stacey L. Clardy,Justine V. Cohen,Jorg Dietrich,Michael Dougan,Christopher T. Doughty,Divyanshu Dubey,Jeffrey M. Gelfand,Jeffrey T. Guptill,Douglas B. Johnson,Vern C. Juel,Robert Kadish,Noah Kolb,Nicole R. LeBoeuf,Jenny J. Linnoila,Andrew L. Mammen,Maria Martinez-Lage,Meghan J. Mooradian,Jarushka Naidoo,Jarushka Naidoo,Tomas G. Neilan,David A. Reardon,Krista M. Rubin,Bianca Santomasso,Ryan J. Sullivan,Nancy Wang,Karin Woodman,Leyre Zubiri,William C Louv,Kerry L. Reynolds +37 more
TL;DR: In this article, the authors developed consensus guidance for an approach to irAE-Ns including disease definitions and severity grading, based on numeric ratings using the RAND/University of California Los Angeles (UCLA) Appropriateness Method with prespecified definitions.
References
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Francesc Graus,Maarten J. Titulaer,Ramani Balu,Susanne M. Benseler,Christian G. Bien,Tania Cellucci,Irene Cortese,Russell C. Dale,Jeffrey M. Gelfand,Michael D. Geschwind,Carol A. Glaser,Jérôme Honnorat,Romana Höftberger,Takahiro Iizuka,Sarosh R. Irani,Eric Lancaster,Frank Leypoldt,Harald Prüss,Alexander Rae-Grant,Markus Reindl,Myrna R. Rosenfeld,Kevin Rostasy,Albert Saiz,Arun Venkatesan,Angela Vincent,Klaus Peter Wandinger,Patrick Waters,J. Dalmau,J. Dalmau +28 more
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Journal ArticleDOI
Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline
Julie R. Brahmer,Christina Lacchetti,Bryan J. Schneider,Michael B. Atkins,Kelly J. Brassil,Jeffrey M. Caterino,Ian Chau,Marc S. Ernstoff,Jennifer M. Gardner,Pamela K. Ginex,Sigrun Hallmeyer,Jennifer Holter Chakrabarty,Natasha B. Leighl,Jennifer S. Mammen,David F. McDermott,Aung Naing,Loretta J. Nastoupil,Tanyanika Phillips,Laura Diane Porter,Igor Puzanov,Cristina A. Reichner,Bianca Santomasso,Carole Seigel,Alexander Spira,Maria E. Suarez-Almazor,Yinghong Wang,Jeffrey S. Weber,Jeffrey S. Weber,Jedd D. Wolchok,John A. Thompson +29 more
TL;DR: Recommendations for specific organ system-based toxicity diagnosis and management are presented and, in general, permanent discontinuation of ICPis is recommended with grade 4 toxicities, with the exception of endocrinopathies that have been controlled by hormone replacement.
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Nivolumab versus chemotherapy in patients with advanced melanoma who progressed after anti-CTLA-4 treatment (CheckMate 037): a randomised, controlled, open-label, phase 3 trial.
Jeffrey S. Weber,Sandra P. D'Angelo,David R. Minor,F. Stephen Hodi,Ralf Gutzmer,Bart Neyns,Christoph Hoeller,Nikhil I. Khushalani,Wilson H. Miller,Christopher D. Lao,Gerald P. Linette,Luc Thomas,Paul Lorigan,Kenneth F. Grossmann,Jessica C. Hassel,Michele Maio,Mario Sznol,Paolo A. Ascierto,Peter Mohr,Bartosz Chmielowski,Alan H. Bryce,Inge Marie Svane,Jean-Jacques Grob,Angela M. Krackhardt,Christine Horak,Alexandre Lambert,Arvin Yang,James Larkin +27 more
TL;DR: Nivolumab led to a greater proportion of patients achieving an objective response and fewer toxic effects than with alternative available chemotherapy regimens for patients with advanced melanoma that has progressed after ipilimumab or ipilicumab and a BRAF inhibitor.
Journal ArticleDOI
Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
J.B.A.G. Haanen,Franck Carbonnel,Caroline Robert,Keith M. Kerr,Solange Peters,James Larkin,K. Jordan +6 more
TL;DR: Calcium, CRP, C-reactive protein, CT, computed tomography, ESR, sedimentation rate, and checkpoint are used to estimate the concentration of phosphorous in the sediments.
Journal ArticleDOI
Fatal Toxic Effects Associated With Immune Checkpoint Inhibitors: A Systematic Review and Meta-analysis
Daniel Y. Wang,Joe-Elie Salem,Joe-Elie Salem,Justine V. Cohen,Sunandana Chandra,Christian Menzer,Fei Ye,Shilin Zhao,Satya Das,Kathryn E. Beckermann,Lisa Ha,W. Kimryn Rathmell,Kristin K. Ancell,Justin M. Balko,Caitlin Bowman,Elizabeth J. Davis,David D. Chism,Leora Horn,Georgina V. Long,Matteo S. Carlino,Bénédicte Lebrun-Vignes,Zeynep Eroglu,Jessica C. Hassel,Alexander M. Menzies,Jeffrey A. Sosman,Ryan J. Sullivan,Javid Moslehi,Douglas B. Johnson +27 more
TL;DR: In the largest evaluation of fatal ICI-associated toxic effects published to date to the authors' knowledge, early onset of death with varied causes and frequencies depending on therapeutic regimen is observed.
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Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline
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