Multinational Association of Supportive Care in Cancer (MASCC) 2020 clinical practice recommendations for the management of immune-related adverse events : pulmonary toxicity

dc.contributor.authorShannon, Vickie R.
dc.contributor.authorAnderson, Ronald
dc.contributor.authorBlidner, Ada Gabriela
dc.contributor.authorChoi, Jennifer
dc.contributor.authorCooksley, Tim
dc.contributor.authorDougan, Michael
dc.contributor.authorGlezerman, Ilya
dc.contributor.authorGinex, Pamela
dc.contributor.authorGirotra, Monica
dc.contributor.authorGupta, Dipti
dc.contributor.authorJohnson, Douglas
dc.contributor.authorSuarez-Almazor, Maria
dc.contributor.authorRapoport, Bernardo Leon
dc.contributor.emailbernardo.rapoport@up.ac.zaen_ZA
dc.date.accessioned2020-10-26T10:48:38Z
dc.date.issued2020-12
dc.description.abstractThe immune checkpoints associated with the CTLA-4 and PD-1 pathways are critical modulators of immune activation. These pathways dampen the immune response by providing brakes on activated T cells, thereby ensuring more uniform and controlled immune reactions and avoiding immune hyper-responsiveness and autoimmunity. Cancer cells often exploit these regulatory controls through a variety of immune subversion mechanisms, which facilitate immune escape and tumor survival. Immune checkpoint inhibitors (ICI) effectively block negative regulatory signals, thereby augmenting immune attack and tumor killing. This process is a double-edged sword in which release of regulatory controls is felt to be responsible for both the therapeutic efficacy of ICI therapy and the driver of immune-related adverse events (IrAEs). These adverse immune reactions are common, typically low-grade and may affect virtually every organ system. In the early clinical trials, lung IrAEs were rarely described. However, with ever-expanding clinical applications and more complex ICI-containing regimens, lung events, in particular, pneumonitis, have become increasingly recognized. ICI-related lung injury is clinically distinct from other types of lung toxicity and may lead to death in advanced stage disease. Thus, knowledge regarding the key characteristics and optimal treatment of lung-IrAEs is critical to good outcomes. This review provides an overview of lung-IrAEs, including risk factors and epidemiology, as well as clinical, radiologic, and histopathologic features of ICI-related lung injury. Management principles for ICI-related lung injury, including current consensus on steroid refractory pneumonitis and the use of other immune modulating agents in this setting are also highlighted.en_ZA
dc.description.departmentImmunologyen_ZA
dc.description.embargo2021-08-20
dc.description.librarianhj2020en_ZA
dc.description.sponsorshipThe Cancer Association of South Africa (CANSA), the National Research Foundation (NRF) of South Africa, the NIH/NCI (Cancer Center Support Grant P30 CA008748).en_ZA
dc.description.urihttp://link.springer.com/journal/520en_ZA
dc.identifier.citationShannon, V.R., Anderson, R., Blidner, A. et al. Multinational Association of Supportive Care in Cancer (MASCC) 2020 clinical practice recommendations for the management of immune-related adverse events: pulmonary toxicity. Support Care in Cancer 28, 6145–6157 (2020). https://doi.org/10.1007/s00520-020-05708-2.en_ZA
dc.identifier.issn0941-4355 (print)
dc.identifier.issn1433-7339 (online)
dc.identifier.other10.1007/s00520-020-05708-2
dc.identifier.urihttp://hdl.handle.net/2263/76606
dc.language.isoenen_ZA
dc.publisherSpringeren_ZA
dc.rights© Springer-Verlag GmbH Germany, part of Springer Nature 2020. The original publication is available at : http://link.springer.com/journal/520.en_ZA
dc.subjectCanceren_ZA
dc.subjectDrug-induced pneumonitisen_ZA
dc.subjectDrug toxicityen_ZA
dc.subjectImmune-related adverse events (IrAEs)en_ZA
dc.subjectImmune checkpoint inhibitorsen_ZA
dc.subjectImmunotherapyen_ZA
dc.titleMultinational Association of Supportive Care in Cancer (MASCC) 2020 clinical practice recommendations for the management of immune-related adverse events : pulmonary toxicityen_ZA
dc.typePostprint Articleen_ZA

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