Immunotherapy in metastatic melanoma: a novel scenario of new toxicities and their management.

IF 1 Q4 ONCOLOGY Melanoma Management Pub Date : 2019-11-08 DOI:10.2217/mmt-2019-0005

Ester Simeone, Antonio M Grimaldi, Lucia Festino, Claudia Trojaniello, Maria G Vitale, Vito Vanella, Marco Palla, Paolo A Ascierto

引用次数: 19

Abstract

Checkpoint inhibitors can cause an imbalance in immune tolerance that may clinically manifest as immune-related adverse events (irAEs). These events may involve many organs and tissues, including the skin, gastrointestinal (GI) tract, liver, endocrine system, kidneys, central nervous system (CNS), eyes and lungs. The incidence of irAEs appears to be lower with anti-programmed death antigen-1/programmed death antigen-ligand-1 agents than with the anti-cytotoxic T-lymphocyte-associated protein-4 antibody ipilimumab. Combined immunotherapy does not appear to be associated with novel safety signals compared with monotherapy, but more organs may be involved. Increased experience and the use of algorithms for the most common irAEs have resulted in severe toxicity and related deaths being reduced. However, continuous vigilance, especially regarding less common events, is needed to better characterize the wide spectrum of clinical manifestations.

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转移性黑色素瘤的免疫治疗:新毒性的新情况及其管理。

检查点抑制剂可导致免疫耐受失衡，这可能在临床上表现为免疫相关不良事件(irAEs)。这些事件可能涉及许多器官和组织，包括皮肤、胃肠道、肝脏、内分泌系统、肾脏、中枢神经系统、眼睛和肺部。与抗细胞毒性t淋巴细胞相关蛋白4抗体ipilimumab相比，抗程序性死亡抗原-1/程序性死亡抗原配体-1药物的irae发生率似乎更低。与单药治疗相比，联合免疫治疗似乎没有新的安全信号，但可能涉及更多的器官。经验的增加和对最常见的放射学反应的算法的使用减少了严重毒性和相关死亡。然而，需要持续的警惕，特别是对不常见的事件，以更好地描述广泛的临床表现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Melanoma Management ONCOLOGY-

CiteScore

5.10

自引率

0.00%

发文量

审稿时长

13 weeks

期刊介绍： Skin cancer is on the rise. According to the World Health Organization, 132,000 melanoma skin cancers occur globally each year. While early-stage melanoma is usually relatively easy to treat, once disease spreads prognosis worsens considerably. Therefore, research into combating advanced-stage melanoma is a high priority. New and emerging therapies, such as monoclonal antibodies, B-RAF and KIT inhibitors, antiangiogenic agents and novel chemotherapy approaches hold promise for prolonging survival, but the search for a cure is ongoing. Melanoma Management publishes high-quality peer-reviewed articles on all aspects of melanoma, from prevention to diagnosis and from treatment of early-stage disease to late-stage melanoma and metastasis. The journal presents the latest research findings in melanoma research and treatment, together with authoritative reviews, cutting-edge editorials and perspectives that highlight hot topics and controversy in the field. Independent drug evaluations assess newly approved medications and their role in clinical practice. Key topics covered include: Risk factors, prevention and sun safety education Diagnosis, staging and grading Surgical excision of melanoma lesions Sentinel lymph node biopsy Biological therapies, including immunotherapy and vaccination Novel chemotherapy options Treatment of metastasis Prevention of recurrence Patient care and quality of life.