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Bryan J. Schneider, Jarushka Naidoo, Bianca Santomasso, Christina Lacchetti, Sherry Adkins, Milan Anadkat, Michael B. Atkins, Kelly J. Brassil, Jeffrey M. Caterino, Ian Chau and 22 more
PURPOSE: To increase awareness, outline strategies, and offer guidance on the recommended management of immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitor (ICPi) therapy. METHODS: A multidisciplinary panel of medical oncology, dermatology, gastroenterology, rheumatology, pulmonology, endocrinology, neurology, hematology, emergency medicine, nursing, trialists, and advocacy experts was convened to update the guideline. Guideline development involved a systematic literature review and an informal consensus process. The systematic review focused on evidence published from 2017 through 2021. RESULTS: A total of 175 studies met the eligibility criteria of the systematic review and were pertinent to the development of the recommendations. Because of the paucity of high-quality evidence, recommendations are based on expert consensus. RECOMMENDATIONS: Recommendations for specific organ system-based toxicity diagnosis and management are presented. While management varies according to the organ system affected, in general, ICPi therapy should be continued with close monitoring for grade 1 toxicities, except for some neurologic, hematologic, and cardiac toxicities. ICPi therapy may be suspended for most grade 2 toxicities, with consideration of resuming when symptoms revert ≤ grade 1. Corticosteroids may be administered. Grade 3 toxicities generally warrant suspension of ICPis and the initiation of high-dose corticosteroids. Corticosteroids should be tapered over the course of at least 4-6 weeks. Some refractory cases may require other immunosuppressive therapy. In general, permanent discontinuation of ICPis is recommended with grade 4 toxicities, except for endocrinopathies that have been controlled by hormone replacement. Additional information is available at www.asco.org/supportive-care-guidelines.
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Schneider, B. J., Naidoo, J., Santomasso, B., Lacchetti, C., Adkins, S., Anadkat, M., Atkins, M. B., Brassil, K. J., Caterino, J. M., Chau, I., Davies, M. J., Ernstoff, M. S., Fecher, L. A., Ghosh, M., Jaiyesimi, I., Mammen, J. S., Naing, A., Nastoupil, L. J., Phillips, T., … Bollin, K. (2021). Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update. Journal of Clinical Oncology, 39(36), 4073–4126. https://doi.org/10.1200/jco.21.01440
Schneider, Bryan J., et al. "Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update." Journal of Clinical Oncology, vol. 39, no. 36, 2021, pp. 4073–4126, https://doi.org/10.1200/jco.21.01440.
Schneider, Bryan J., Jarushka Naidoo, Bianca Santomasso, Christina Lacchetti, Sherry Adkins, Milan Anadkat, Michael B. Atkins, et al. "Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update." Journal of Clinical Oncology 39, no. 36 (2021): 4073–4126. https://doi.org/10.1200/jco.21.01440.
Schneider B. J., Naidoo J., Santomasso B. [и др.] Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update // Journal of Clinical Oncology. — 2021. — Vol. 39, № 36. — P. 4073–4126. — URL: https://doi.org/10.1200/jco.21.01440
@article{schneider2021management,
title = {{Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update}},
author = {Bryan J. Schneider and Jarushka Naidoo and Bianca Santomasso and Christina Lacchetti and Sherry Adkins and Milan Anadkat and Michael B. Atkins and Kelly J. Brassil and Jeffrey M. Caterino and Ian Chau and Marianne J. Davies and Marc S. Ernstoff and Leslie Anne Fecher and Monalisa Ghosh and Ishmael Jaiyesimi and Jennifer S. Mammen and Aung Naing and Loretta J. Nastoupil and Tanyanika Phillips and Laura D. Porter and Cristina A. Reichner and Carole Seigel and Jung-Min Song and Alexander Spira and Maria Suarez-Almazor and Umang Swami and John A. Thompson and Praveen Vikas and Yinghong Wang and Jeffrey S. Weber and Pauline Funchain and Kathryn Bollin},
journal = {Journal of Clinical Oncology},
year = {2021},
volume = {39},
number = {36},
pages = {4073--4126},
doi = {10.1200/jco.21.01440},
url = {https://doi.org/10.1200/jco.21.01440}
}TY - JOUR AU - Schneider, Bryan J. AU - Naidoo, Jarushka AU - Santomasso, Bianca AU - Lacchetti, Christina AU - Adkins, Sherry AU - Anadkat, Milan AU - Atkins, Michael B. AU - Brassil, Kelly J. AU - Caterino, Jeffrey M. AU - Chau, Ian AU - Davies, Marianne J. AU - Ernstoff, Marc S. AU - Fecher, Leslie Anne AU - Ghosh, Monalisa AU - Jaiyesimi, Ishmael AU - Mammen, Jennifer S. AU - Naing, Aung AU - Nastoupil, Loretta J. AU - Phillips, Tanyanika AU - Porter, Laura D. AU - Reichner, Cristina A. AU - Seigel, Carole AU - Song, Jung-Min AU - Spira, Alexander AU - Suarez-Almazor, Maria AU - Swami, Umang AU - Thompson, John A. AU - Vikas, Praveen AU - Wang, Yinghong AU - Weber, Jeffrey S. AU - Funchain, Pauline AU - Bollin, Kathryn TI - Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update JO - Journal of Clinical Oncology VL - 39 IS - 36 SP - 4073 EP - 4126 PY - 2021 DA - 2021/11/01 DO - 10.1200/jco.21.01440 UR - https://doi.org/10.1200/jco.21.01440 ER -
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