Updated Brazilian guidelines for the management of immune-related adverse events associated with checkpoint inhibitors - edition 2.0

ABSTRACT

Immunotherapy (IT) in the form of monoclonal antibodies targeting coreceptors involved in the modulation of the immune synapse represents a standard of care for patients with distinct malignancies. Over the past years, evidences supporting the clinical use of IT both in monotherapy, as well as in combinatorial regimens, grew dramatically, leading to multiple regulatory approvals. With the expanding clinical incorporation of IT, understanding the mechanisms and management of the adverse events (AE) associated with this class of drugs is of utmost importance for professionals involved in patient care. In 2017, the Brazilian Society of Clinical Oncology (SBOC) issued the initial version of the “Brazilian guidelines for the management of immune-related toxicities associated with checkpoint inhibitors”. In this article, we aimed to update general and specific aspects related to immune-related AEs associated with the use of immune-checkpoint inhibitors, including emerging evidences and updated algorithms for the most frequent clinical manifestations.

RESUMO

A imunoterapia (IT) na forma de anticorpos monoclonais direcionados a correceptores envolvidos na modulação da sinapse imune, representa um padrão de tratamento para pacientes com neoplasias distintas. Nos últimos anos, as evidências que apoiam o uso clínico da TI tanto em monoterapia quanto em regimes combinatórios cresceram dramaticamente, levando a várias aprovações regulatórias. Com a crescente incorporação clínica da TI, entender os mecanismos e o manejo dos eventos adversos (EA) associados a essa classe de medicamentos é de extrema importância para os profissionais envolvidos no cuidado ao paciente. Em 2017, a Sociedade Brasileira de Oncologia Clínica (SBOC) publicou a versão inicial das “Diretrizes brasileiras para o manejo de toxicidades imunorrelacionadas associadas a inibidores de checkpoint”. Neste artigo, buscamos atualizar aspectos gerais e específicos relacionados aos EAs relacionados ao sistema imunológico associados ao uso de inibidores de checkpoint imunológico, incluindo evidências emergentes e algoritmos atualizados para as manifestações clínicas mais frequentes.

Headings:

Immunotherapy - Practice guideline - Adverse effects - Immune-checkpoint inhibitors

Descritores:

Imunoterapia - Orientação prática - Efeitos adversos - Inibidores de checkpoint imunológico

^* Brazilian Society of Clinical Oncology Task Force.

Publikationsverlauf

Eingereicht: 13. Oktober 2021

Angenommen: 15. Oktober 2021

Artikel online veröffentlicht:
06. Mai 2022

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