Unleashing the Immune System With Checkpoint Inhibitors in Non–Small Cell Lung Cancer: Clinical Review of Adverse Events
University of Illinois Hospital and Health Sciences System—Pharmacy Practice, Chicago, Illinois
Author’s disclosures of potential conflicts of interest are found at the end of this article.
Sandra Cuellar, PharmD, BCOP, University of Illinois Hospital and Health Sciences System—Pharmacy Practice, 833 S. Wood Street, MC 886, Chicago, IL 60612-7236. E-mail: scuell1@uic.edu
J Adv Pract Oncol 2017;8:65–75 | https://doi.org/10.6004/jadpro.2017.8.5.18 | © 2017 Harborside Press®
ABSTRACT
Immunotherapy checkpoint inhibitors have dramatically changed our management of metastatic non–small cell lung cancer (NSCLC). Efficacy data have supported immune checkpoint inhibitors as potential first-line options as monotherapy or in combination with chemotherapy. In addition, they are approved as second-line options after a platinum doublet. Their efficacy represents an unprecedented milestone in metastatic NSCLC. In this new age of immunotherapy, health-care professionals are not experienced in the unique side-effect profile that immunotherapy brings to clinical practice. In general, immune checkpoint inhibitors are well tolerated, but fatal adverse events can occur. Therefore, it is imperative that health-care professionals are educated on the monitoring, identification, and management of the immune-related adverse events (irAEs) that can occur with immune checkpoint inhibitors. This article will review the mechanisms of action, incidence, and management of the most common irAEs that occur with the US Food and Drug Administration–approved checkpoint inhibitors in metastatic NSCLC.
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