MedicalResearch.com Interview with:
Douglas B. Johnson, M.D.
Assistant Professor of Medicine
Clinical Director, Melanoma Research Program
Melanoma, clinical and translational studies
Vanderbilt University Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Immune checkpoint inhibitors produce long-lasting responses in patients with many different types of cancer. However, they may cause serious autoimmune-like side effects that may affect any organ. We used several large databases to determine how often these side effects were fatal, when they occurred, and which types of side effects were responsible.
We found that overall, fatal side effects were uncommon, ranging from 0.3 – 1.3%. However, they tended to occur early on treatment (on average within the first 6 weeks), and affected a variety of organs, including the heart, lungs, colon, liver, and brain. There was a dramatic increase in reporting of fatal toxicities since 2017, likely reflecting the increased use of immune checkpoint inhibitors.
MedicalResearch.com: What should readers take away from your report?
Response: While fatal side effects are uncommon, recognizing immune checkpoint inhibitor toxicities is essential to protect patients. Early diagnosis and treatment with steroids are the most effective ways of managing these side effects.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Developing better preventions and treatments for the most serious side effects is an important next step. While steroids are very effective in most cases, there are a subset of toxicities that are challenging to manage and more effective treatments are needed.
Wang DY, Salem JE, Cohen JV, et al. Fatal toxic effects associated with immune checkpoint inhibitors a systematic review and meta-analysis. [published online September 13, 2013]. JAMA Oncol. doi:10.1001/jamaoncol.2018.3923.
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