Abstract
The immune oncological treatment approach uses immune checkpoint inhibitors to prevent
tumor cells from shutting down the immune system, and thus from escaping immune response.
Following the clinical success of immune checkpoint inhibitors, the number of approved
immune oncological therapies continues to increase. Response rates and overall survival
with anti-PD-1/PD-L1 and CTLA-4 blockade could be further improved by combining both
treatment approaches. However, checkpoint inhibition is associated with a unique spectrum
of side effects termed immune-related adverse events. These typically occur 3 to 6
months after treatment start and resolve with adequate management procedures if detected
early on. Therefore, profound patient education, sensitizing and monitoring are mandatory.
We describe in this article selected frequent and rare adverse events that are clinically
relevant. Furthermore, using case reports, interdisciplinary experts share their practice-based
experience in the management of frequent pneumonic, endocrine, and gastro-intestinal
immune-related adverse events.
Aufgrund ihres Wirkmechanismus an den Effektorzellen des Immunsystems haben Immuncheckpoint-Inhibitoren
(CPI) ein einzigartiges Nebenwirkungsprofil. Die meisten dieser immunvermittelten
Nebenwirkungen (imUE) treten 3 – 6 Monate nach Therapiebeginn auf. Frühzeitig erkannt
sind sie in der Regel bei geeignetem Management reversibel. Daher sind eine gründliche
Aufklärung, Sensibilisierung sowie ein regelmäßiges Monitoring der Patienten notwendig.
Schlüsselwörter Immuncheckpoint-Inhibitoren - CPI - immunvermittelte Nebenwirkung - imUE - NW - PD-1/PD-L1
- CTLA-4 - NW-Management
Key words immune checkpoint inhibitor - immune-related adverse event - PD-1/PD-L1 - CTLA-4 -
adverse event management
