Diagnosis and management of immune-related adverse effects of immune checkpoint therapy in the emergency department.
adverse events
cancer immunotherapy
emergency department
immune checkpoint inhibitors
immune‐mediated
Journal
Journal of the American College of Emergency Physicians open
ISSN: 2688-1152
Titre abrégé: J Am Coll Emerg Physicians Open
Pays: United States
ID NLM: 101764779
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
08
02
2020
revised:
02
07
2020
accepted:
13
07
2020
entrez:
4
1
2021
pubmed:
5
1
2021
medline:
5
1
2021
Statut:
epublish
Résumé
Rapid advances in cancer immunotherapy using immune checkpoint inhibitors have led to significantly improved survival. Rapid identification of the toxicity syndromes associated with these therapeutic agents is very important for emergency physicians because the population of patients diagnosed with cancer is increasing and cancer therapies including immune checkpoint inhibitors have become the first-line treatment for more and more types of cancer. The emergency medicine literature lags behind rapid advances in oncology, and oncology guidelines for rapid recognition and management of these emerging toxicity syndromes are not familiar to emergency physicians. In this review article, we discuss the clinical presentation and management of immune-related adverse effects during the critical first hours of emergency care. We also suggest a workflow for the recognition and treatment of emergencies arising from serious immune-related adverse effects, including but not limited to colitis, adrenal crisis, myocarditis, pneumonitis, myasthenic crisis, diabetic ketoacidosis, bullous pemphigus, and hemophagocytic lymphohistiocytosis. Rapid advances in cancer therapy are bringing new diagnostic and therapeutic challenges to emergency providers, and therefore it is crucial to raise awareness and provide guidelines for the management of new treatment-related toxicities.
Identifiants
pubmed: 33392573
doi: 10.1002/emp2.12209
pii: EMP212209
pmc: PMC7771833
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1637-1659Subventions
Organisme : NIGMS NIH HHS
ID : T32 GM075766
Pays : United States
Informations de copyright
© 2020 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of the American College of Emergency Physicians.
Déclaration de conflit d'intérêts
Dr. Yeung was a member of an expert panel for Celgene, Inc. Dr. Yeung had funding support from Bristol‐Myer Squibb, Inc. and DepoMed, Inc.
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