![]() ![]() ![]() Often, strategies that modulate endogenous regulatory immune mechanisms broadly enhance or activate the immune system. Cancer cells actively employ tactics to evade, delay, alter, or attenuate the anti-tumor immune response. Generally, these approaches fall under a “passive” immunotherapy approach, which uses therapies (e.g., antibody-drug conjugates) to recruit effector cells/molecules of the immune system to directly attack tumor cells, and “active” immune approaches (e.g., CAR-T, type I interferons, anti-CTLA4/PD-1/PD-L1 antibodies), which modulate endogenous regulatory immune mechanisms to enhance immune system activation. This paper reviews immune checkpoint inhibitors (ICIs) including their mechanisms of action, usage, associated irAEs, and their management.Ĭancer immunotherapy has the goal of enhancing a patient’s intrinsic immune processes in order to mount a successful immune response against tumor cells. ![]() Generally, most patients with low grade irAEs are eligible for re-challenge with ICIs, and the use of corticosteroids to address an irAE is not associated with poorer patient outcomes. ![]() Careful assessment of patients for irAEs through history taking, physical exam, and routine laboratory assessments are key to identifying irAEs at early stages, when they can potentially be managed more easily and before progressing to higher grades or more serious effects. This activation occurs broadly and as a result, activation is supraphysiologic and relatively non-specific, which can lead to immune-related adverse events (irAEs), the frequency of which depends on the patient, the cancer type, and the specific ICI antibody. Immune checkpoint inhibitors (ICIs) modulate endogenous regulatory immune mechanisms to enhance immune system activation, and have become the mainstay of therapy in many cancer types. Cancer immunotherapy has the goal of enhancing a patient’s intrinsic immune processes in order to mount a successful immune response against tumor cells. ![]()
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