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Artykuły w czasopismach na temat "Immune-related adverse effect"
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Bangalore Kumar, Anagha, Alan Bryce, Prakash Vishnu, Svetomir Markovic i Marian McEvoy. "Associations of Cutaneous Immune-Related Adverse Effects of Immunotherapy With Treatment Response in Patients With Metastatic Melanoma". SKIN The Journal of Cutaneous Medicine 5, nr 2 (6.03.2021): 108–17. http://dx.doi.org/10.25251/skin.5.2.5.
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Background: Dermatologic toxicity is the most common immune-related adverse effect of cancer immunotherapy.
Methods: We retrospectively reviewed the health records of adult (≥18 years) melanoma patients who received ipilimumab, nivolumab, or pembrolizumab from January 1, 2011, through September 15, 2017, at Mayo Clinic. The χ2 test was used to assess the association between development of a cutaneous immune-related adverse effect and antitumoral response to the immune checkpoint inhibitors. Odds ratios were calculated with logistic regression models and were adjusted for sex and immunotherapeutic drugs. We described the various cutaneous immune-related adverse effects and assessed the response to immunotherapy (each patient’s objective clinical response was categorized as favorable [complete or partial response] or unfavorable). We then determined whether development of a cutaneous immune-related adverse effect was associated with the clinical response.
Results: Of 690 melanoma patients, 232 (33.6%) had a cutaneous immune-related adverse effect. The most common effects were dermatitis (21.4%), pruritus (5.5%), and vitiligo (4.2%). Median (range) time to onset of dermatitis was 3 (0-7) weeks; lichenoid dermatitis, 12 (6-18) weeks; and vitiligo, 40 (12-96) weeks. Development of a cutaneous immune-related adverse effect was significantly associated with favorable clinical response.
Conclusions: Development of cutaneous immune-related adverse effects is associated with favorable responses to nivolumab, ipilimumab, pembrolizumab, and ipilimumab plus nivolumab therapy in patients with metastatic melanoma.
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Williams, Kiersten J., Dennis W. Grauer, David W. Henry i Michelle L. Rockey. "Corticosteroids for the management of immune-related adverse events in patients receiving checkpoint inhibitors". Journal of Oncology Pharmacy Practice 25, nr 3 (9.12.2017): 544–50. http://dx.doi.org/10.1177/1078155217744872.
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Introduction Due to enhanced T-cell activity, immune checkpoint inhibitors cause immune-related adverse effects. Corticosteroids are the mainstay of immune-related adverse effect management but the optimal strategy has not been determined, putting patients at risk for steroid-related adverse effects and potentially decreased efficacy of immunotherapy. This study aims to characterize the use of corticosteroids for the management of immune-related adverse effect. Methods and materials A retrospective, single-center evaluation of patients receiving checkpoint inhibitors was conducted. The primary objective was to evaluate corticosteroid use for immune-related adverse effects, including starting dose, taper strategy, total duration, and resumption of immunotherapy. Secondary objective was to describe the incidence and significance of hyperglycemia. Results One hundred and three patients met inclusion criteria and experienced 123 immune-related adverse effects. Prednisone was used most commonly (67%) at an average starting dose of 0.88 mg/kg (range 0.07–17.0). On average, steroid tapers began 9.2 days after initiation (range 0–89) and were continued for a total of 84.2 days (range 3–693). In 21.1% of cases, checkpoint inhibitor therapy was not delayed and 68.6% resumed checkpoint inhibitors, while the patient was taking steroids (30.4 mg prednisone on average, range 5–80). On average, checkpoint inhibitor therapy was resumed 18.6 days after detection of immune-related adverse effect (range 0–150). Clinically relevant hyperglycemia occurred in 8.9%. Conclusion Utilization of steroids for immune-related adverse effect at our institution is highly variable. The majority of patients received prolonged courses of steroids and resumed checkpoint inhibitor therapy with concomitant steroids above recommended doses. Additional monitoring for hyperglycemia and other steroid associated adverse effects should be considered.
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Muir, Christopher A., Roderick J. Clifton-Bligh, Georgina V. Long, Richard A. Scolyer, Serigne N. Lo, Matteo S. Carlino, Venessa H. M. Tsang i Alexander M. Menzies. "Thyroid Immune-related Adverse Events Following Immune Checkpoint Inhibitor Treatment". Journal of Clinical Endocrinology & Metabolism 106, nr 9 (20.04.2021): e3704-e3713. http://dx.doi.org/10.1210/clinem/dgab263.
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Abstract Context Thyroid dysfunction occurs commonly following immune checkpoint inhibition. The etiology of thyroid immune-related adverse events (irAEs) remains unclear and clinical presentation can be variable. Objective This study sought to define thyroid irAEs following immune checkpoint inhibitor (ICI) treatment and describe their clinical and biochemical associations. Methods We performed a retrospective cohort study of thyroid dysfunction in patients with melanoma undergoing cytotoxic T-lymphocyte antigen-4 (CTLA-4) and/or programmed cell death protein-1 (PD-1) based ICI treatment from November 1, 2009, to December 31, 2019. Thyroid function was measured at baseline and at regular intervals following the start of ICI treatment. Clinical and biochemical features were evaluated for associations with ICI-associated thyroid irAEs. The prevalence of thyroid autoantibodies and the effect of thyroid irAEs on survival were analyzed. Results A total of 1246 patients were included with a median follow-up of 11.3 months. Five hundred and eighteen (42%) patients developed an ICI-associated thyroid irAE. Subclinical thyrotoxicosis (n = 234) was the most common thyroid irAE, followed by overt thyrotoxicosis (n = 154), subclinical hypothyroidism (n = 61), and overt hypothyroidism (n = 39). Onset of overt thyrotoxicosis occurred a median of 5 weeks (interquartile range [IQR] 2-8) after receipt of a first dose of ICI. Combination immunotherapy was strongly associated with development of overt thyrotoxicosis (odds ratio [OR] 10.8, 95% CI 4.51-25.6 vs CTLA-4 monotherapy; P < .001), as was female sex (OR 2.02, 95% CI 1.37-2.95; P < .001) and younger age (OR 0.83 per 10 years, 95% CI 0.72-0.95; P = .007). By comparison, median onset of overt hypothyroidism was 14 weeks (IQR 8-25). The frequency of overt hypothyroidism did not differ between different ICI types. The strongest associations for hypothyroidism were higher baseline thyroid-stimulating hormone (OR 2.33 per mIU/L, 95% CI 1.61-3.33; P < .001) and female sex (OR 3.31, 95% CI 1.67-6.56; P = .01). Overt thyrotoxicosis was associated with longer progression free survival (hazard ratio [HR] 0.68, 95% CI 0.49-0.94; P = .02) and overall survival (HR 0.57, 95% CI 0.39-0.84; P = .005). There was no association between hypothyroidism and cancer outcomes. Conclusion Thyroid irAEs are common and there are multiple distinct phenotypes. Different thyroid irAE subtypes have unique clinical and biochemical associations, suggesting potentially distinct etiologies for thyrotoxicosis and hypothyroidism arising in this context.
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Bansal, Aditi, Ankur Singla, Davinder Paul i Sukhjot Kaur. "Pembrolizumab-induced lichen planus: A rare immune-related adverse side effect". Indian Dermatology Online Journal 14, nr 3 (2023): 391. http://dx.doi.org/10.4103/idoj.idoj_377_22.
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Lima, Gian, Adriana Kahn, Shashank Sama i Jacqueline Savage. "Aseptic Meningitis as an Immune-Related Adverse Event after Pembrolizumab". Case Reports in Oncological Medicine 2019 (4.11.2019): 1–2. http://dx.doi.org/10.1155/2019/7183747.
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Introduction. The management of patients with advanced malignancies is challenging, although recent advances with immunotherapy have shown better outcomes. Pembrolizumab has been associated with a variety of immune-related side effects, but the occurrence of aseptic meningitis is rare. Case. A 55-year-old male with a history of metastatic lung adenocarcinoma previously treated with pembrolizumab presented with persistent severe headaches and photophobia. Subsequent workup with cerebrospinal fluid analysis showed elevated opening pressure, increased nucleated cells with 30% lymphocytes, elevated protein levels, and normal glucose levels. The patient was started on high doses of IV steroids and progressed with significant improvement of his symptoms. Discussion. Given the rarity of this side effect, this case is a reminder that immune checkpoint inhibitors can cause aseptic meningitis and its early recognition is important for initiation of therapy with steroids and prompt discontinuation of the immunotherapy agent.
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Kim, Won Myung, Mun Su Park, Dong Hyun Seo, Jung Yun Lee i Jung Yoon Pyo. "Immune-related Adverse Effect after BNT162b2 Vaccination with Parallel Immune Checkpoint Inhibitor Therapy: A Case Report". Korean Journal of Medicine 98, nr 2 (1.04.2023): 93–97. http://dx.doi.org/10.3904/kjm.2023.98.2.93.
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COVID-19 vaccination is essential in cancer patients. However, there is limited evidence of the prognosis of these patients, especially for those taking immune checkpoint inhibitors (ICIs). We present a patient on pembrolizumab for advanced endometrioid adenocarcinoma experiencing continuous diarrhea and subsequent episodes of fever with pain in multiple joints following a second dose of the BNT162b2 mRNA COVID-19 vaccine. An ICI-induced immune-related adverse effect (irAE) was the main diagnosis; cytokine release syndrome and rheumatoid arthritis were also considered. Notably, the novel irAE occurred after the 19th pembrolizumab trial, highlighting the potential effect of changes in systemic immunogenicity after BNT162b2 vaccination. Ultimately, the patient was treated with steroid, which alleviated her symptoms. Here, we report a rare adverse effect after COVID-19 vaccination in an endometrioid carcinoma patient on ICI therapy. This report shows that there is a need to consider and investigate vaccine-related adverse events.
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Brinzevich, Daria, Virginia Falvello, Michael D. Green i Alex Bryant. "Impact of commonly prescribed medications on immune-related adverse events." Journal of Clinical Oncology 42, nr 16_suppl (1.06.2024): e14704-e14704. http://dx.doi.org/10.1200/jco.2024.42.16_suppl.e14704.
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e14704 Background: Commonly used medications may have immune modulating properties that affect the risk of immune-related adverse events (irAEs) after immune checkpoint inhibitor (ICI) therapy. Methods: We identified 27,998 patients who received ICI from 2010 to 2023 in the national Veterans Affairs system, matched to 66,488 historical control patients treated with non-ICI systemic therapies. We extracted medication usage in the year before therapy start. We used propensity-weighted Cox regression analysis to assess the effect of each medication on severe irAE (treatment with prolonged course of high-dose steroids, adrenal insufficiency, or new insulin-dependent diabetes). To identify medication effects specific to ICI vs. other therapies, we report the adjusted hazard ratio (aHR) for each medication stratified by cohort (ICI vs. historical control) and the p-value for the interaction between each medication class and cohort. Results: Among ICI patients, 52% of patients were treated in the first line, 72% received ICI monotherapy, and 95% received PD-1/PD-L1 inhibitors alone. The most common cancer types were NSCLC (46%), melanoma (10%), and liver cancer (8%). Among 15 medication classes, metformin, loop diuretics, and PPIs were associated with small, marginally statistically significant differences in toxicity among ICI patients, but similar associations were observed in historical control patients (p for interaction >0.18; Table). After adjustment for multiple comparisons, no medication classes were associated with increased risk of severe irAE in ICI patients. Conclusions: Commonly prescribed medication classes have no significant effects on toxicity specific to ICI therapy. [Table: see text]
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Ou, Qiyun, Yunfang Yu, Haitao Zhong, Anlin Li, Yongjian Chen, HaiYu Zhou, Shaopeng Zheng, Luyu Huang i Herui Yao. "Association of immune-related adverse events with immune checkpoint inhibitor efficacy in pancancer." Journal of Clinical Oncology 37, nr 15_suppl (20.05.2019): e14087-e14087. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e14087.
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e14087 Background: Immune-related adverse events (irAEs) have been shown to be associated with the efficacy of immune checkpoint inhibitors in patients with advanced cancer, but the reported effect sizes have varied greatly in previous trials. We did a meta-analysis to assess immune checkpoint inhibitors efficacy and further explored the correlation of irAEs with efficacy in cancer. Methods: We systematically searched database inception to January, 2019 for randomized trials of immune checkpoint inhibitor in patients with advanced cancer that had available data for overall survival (OS) and progression-free survival (PFS), and irAEs. We calculated the pooled hazard ratios (HRs) and 95% confidence intervals [CIs] using a random-effects model, and assessed the association between the irAEs and PFS or OS using coefficient of determination ( R²). The PROSPERO registry number is CRD42017075610. Results: Thirty eight trials with 19,521 patients were included. Compared with conventional therapy, anti-PD-1 or PD-L1 combined with conventional therapy significantly enhanced survival (HR = 0.62, 95% CI 0.53 to 0.72 for PFS; HR = 0.71, 95% CI 0.58 to 0.87 for OS), and anti-PD1 or PD-L1 combined with anti-CTLA4 (HR = 0.75, 95% CI 0.63 to 0.90 for PFS). Anti-CTLA4 plus conventional therapy prolonged PFS (HR = 0.80, 95% CI 0.72 to 0.89) and OS (HR = 0.80, 95% CI 0.66 to 0.96) than conventional therapy alone. Anti-PD1 or PD-L1 outperformed anti-CTLA4 on OS (HR = 0.68, 95% CI 0.57 to 0.81). Significant correlation between treatment efficacy and irAEs was only identified in pneumonitis ( R2 0.59, P = 0.026 for PFS) and diarrhea ( R2 0.22, P = 0.006 for OS). Conclusions: We recommended the concurrent use of immune checkpoint inhibitor and conventional therapy or dual immunotherapy as the most appropriate regimens for advanced cancer. Furthermore, development of pneumonitis and diarrhea were associated with survival outcome of immune checkpoint inhibitors in patients with advanced cancer.
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Hamatake, Kiyonori, i Kazuaki Kojima. "Initiatives for immune-related adverse events by the outpatient pharmacist clinic". Trends in Immunotherapy 6, nr 1 (10.01.2022): 3. http://dx.doi.org/10.24294/ti.v6.i1.1385.
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Early detection is the key in managing side effects because immune-related adverse events (irAEs) are becoming more serious, and their onset time differs. In our hospital, we conducted an outpatient pharmacist clinic for early detection of irAEs by self-care practice for the cases of immune checkpoint inhibitor administration. As a result of a retrospective survey of 207 cases, the percentage of irAEs found by pharmacist’s suggestion of the outpatient pharmacist clinic increased over time, and a high detection ratio was obtained even for irAEs with a late onset time. The incidence of serious irAEs was higher than that in the immediate post-marketing surveillance, and different factors were considered. Although there were some problems, the outpatient pharmacist clinic had a certain effect.
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Sakai, Miho, Yuki Haga, Michiyo Kambe, Koji Nishimura, Ayako Shingyouchi, Tatsuo Miyamura, Kenji Ito i in. "A case of immune-related adverse effect diffuse gastritis induced by nivolumab". Progress of Digestive Endoscopy 98, nr 1 (25.06.2021): 91–92. http://dx.doi.org/10.11641/pde.98.1_91.
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L'Orphelin, Jean-Matthieu. "Ρarticularité cliniques et impacts thérapeutiques des effets indésirables immunο-induits chez les patients atteints d'un mélanοme de stade ΙV". Electronic Thesis or Diss., Normandie, 2024. http://www.theses.fr/2024NORMC406.
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Contexte. Les inhibiteurs de point de contrôle immunitaire sont le traitement de première ligne incontesté des mélanomes de stade IV et sont pourvoyeurs d’effets indésirables, souvent immuno-médiés. Il existe une prise en compte croissante des événements immuno-médiés dans la décision thérapeutique et une volonté d’individualisation des prises en charges des patients atteints de mélanome métastatique. Une caractérisation plus fine ce ces événements permettrait une meilleure prédiction de leur survenue et de leurs impacts. Nos connaissances des événements immuno-médiés proviennent majoritairement des essais cliniques randomisés de phase III, par le recueil des données de sécurité le temps de l’étude. Elles ne permettent pas la mise évidence des signaux de sécurité tardifs, survenant très à distance de l’essai clinique, ou des signaux de sécurité rares, non notifiés dans les publications qui en découlent. Matériel et méthodes. Une méta-analyse de sécurité conduite sur les essais cliniques randomisés de ClinicalTrials.gov vise à identifier des signaux de sécurité rares permettant davantage d’exhaustivité. Nous avons déterminé le type et l’incidence des effets rares (représentés par les effets cardiovasculaires) associés à l’exposition aux inhibiteurs de points de contrôle immunitaire dans le mélanome de stade IV. Des études « post-commercialisation » ont été conduites sur trois bases de données : RIC-Mel et Vigibase® préalablement constituées, et Melskintox, constituée spécifiquement pour le recueil des effets immuno-médiés cutanés. Ces études de « vraie vie » permettent d’interroger le type, l’incidence et l’impact des effets immuno-médiés dermatologiques à risque de sous-notification et de caractériser l’ensemble des effets immuno-médiés tardifs à distance de l’instauration de l’inhibiteur de point de contrôle immunitaire car le suivi issu des essais cliniques randomisés est trop court pour être informatif. Enfin, nous avons discuté la sécurité de réintroduire un inhibiteur de point de contrôle immunitaire après un évènement immuno-médié. Résultats. La méta-analyse nous permet d’identifier certains évènements immuno-médiés non identifiés initialement dans les essais cliniques randomisés car ils sont rares et non systématiquement recherchés, comme certains évènements cardiovasculaires. Ils peuvent pourtant être graves (myocardite, péricardite). Certains, comme la dyslipidémie, laissent supposer un long délai d’apparition, permis par l’allongement de la survie des patients présentant un mélanome et traités par inhibiteurs de points de contrôle immunitaire. En étude de cohorte de vraie vie, d’autres évènements tardifs et sévères peuvent survenir très à distance de l’initiation du traitement (après deux ans) et affecter tous les organes. Les patients atteints d’un mélanome SSM semblent plus à risque de présenter un effet indésirable tardif. Certains évènements immuno-médiés fréquents et rarement graves sont imparfaitement recherchés et la diversité des présentations cliniques peu connue. Les pronostics semblent être différents selon que l’effet immuno-médié cutané est une dermatose inflammatoire bénigne, un trouble pigmentaire, une toxidermie ou une dermatose bulleuse. Enfin, les données de pharmacovigilance concernant la réintroduction sont variables selon l’effet immuno-médié initial, suggérant un taux de récurrence plus élevé pour la néphrite et les évènements immuno-médiés cutanés. Discussion et perspectivesUn évènement immuno-médié doit être connu et reconnu au regard de son impact thérapeutique, et faire l’objet de modalités de surveillance adaptées. La personnalisation du parcours de soin et des propositions thérapeutiques se fera par une connaissance plus fine des données de sécurité et une meilleure caractérisation des évènements immuno-médiésBackground. Immune checkpoint inhibitors are the undisputed first-line treatment for stage IV melanoma, and are associated with adverse events, often immuno-related. Immune-related events are increasingly taken into account in therapeutic decisions, and there is a desire to individualize the management of patients with metastatic melanoma. A more detailed characterization of these events would enable better prediction of their occurrence and impact. Our knowledge of immuno-related events comes mainly from randomized phase III clinical trials, through the collection of safety data for the duration of the study. This does not allow us to identify late-onset safety signals, occurring long after the clinical trial, or rare safety signals not always reported in the publication. . Materials and methods. A safety meta-analysis conducted on randomized clinical trials from ClinicalTrials.gov aims to identify rare safety signals allowing greater comprehensiveness. We determined the type and incidence of rare events (represented by cardiovascular events) associated with exposure to immune checkpoint inhibitors in stage IV melanoma. Post-marketing studies have been carried out on three databases: RIC-Mel and Vigibase®, set up beforehand, and Melskintox, specifically set up to record cutaneous immune-related effects. These “real-life” studies make it possible to investigate the type, incidence and impact of dermatological immune-related events at risk of under-reporting, and to characterize all late-onset immune-related events late after the introduction of the immune checkpoint inhibitor, since follow-up from randomized clinical trials is too short to be informative. Finally, we discussed the safety of reintroducing an immune checkpoint inhibitor after an immuno-related event. Results. The meta-analysis enables us to identify some immuno-related events not initially identified in randomized clinical trials because they are rare and not systematically investigated, such as cardiovascular events. However, they can be serious as myocarditis and pericarditis. Some, such as dyslipidemia, suggest a long delay in onset, made possible by the extended overall survival of melanoma patients treated with immune checkpoint inhibitors. In real-life cohort studies, other severe late-onset events may occur long after from the initiation of treatment (after two years), affecting all organs. Patients with SSM melanoma appear to have a higher risk of late-onset adverse events. Certain frequent and rare serious immune-related events are imperfectly investigated, and the diversity of clinical presentations is poorly understood. The prognosis seems to differ depending on whether the cutaneous immuno-related effect is a benign inflammatory dermatosis, a pigmentary disorder, drug-related rash or bullous dermatosis. Finally, pharmacovigilance data on reintroduction vary according to the initial immune-related event, suggesting a higher recurrence rate for nephritis and cutaneous immuno-related events. Discussion and perspectivesThe occurrence of an immune-related event must be known and recognized with regard to its therapeutic impact, and be the subject of appropriate monitoring modalities. A more detailed knowledge of safety data and a better characterization of immune-related events will enable us to tailor our treatment pathways and proposals
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Soussan, Sarah. "B lymphocytes and autoantibodies in immune-related adverse events following immune checkpoint inhibitors in cancer patients". Electronic Thesis or Diss., Sorbonne université, 2024. https://accesdistant.sorbonne-universite.fr/login?url=https://theses-intra.sorbonne-universite.fr/2024SORUS022.pdf.
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Les anticorps monoclonaux thérapeutiques ciblant les inhibiteurs de checkpoints immunitaires, tels que PD-1 et CTLA-4, ont pour objectif d'induire la réactivation de l'immunité anti-tumorale. Cependant, une limite à l'utilisation de ces immunothérapies anti-cancéreuses est l'émergence de toxicités auto-immunes ou irAEs (« immune-related adverse events »). La survenue d'effets secondaires spécifiquement associés à ce type de traitement est observée chez 30 à 90% des patients. De plus, les toxicités peuvent nécessiter une réduction ou un arrêt de l'immunothérapie. Des premières études ont démontré une importante implication des lymphocytes T, ciblés par les immunothérapies, dans l'émergence d'effets secondaires. Cependant, une contribution importante des lymphocytes B dans les réponses anti-tumorales suggèrent également un rôle de l'immunité humorale dans ces toxicités. Une étude phénotypique et fonctionnelle des lymphocytes B périphériques et des autoanticorps circulants a donc été conduite sur deux cohortes de patients atteints de cancer solide, traités par immunothérapie et développant ou non des toxicités. La caractérisation des lymphocytes B périphériques au cours du traitement a été réalisé par cytométrie spectrale. De plus, un protocole de culture de lymphocytes B triés nous a permis d'étudier leur capacité de production d'anticorps et leur association avec l'émergence de toxicités. Des approches complémentaires ont été réalisées afin d'évaluer l'auto-réactivité sérique et plasmatique des patients au cours de l'immunothérapie, notamment chez des patients développant des effets secondaires cardiaque et/ou musculaire. L'étude des fonctions pathogéniques des auto-anticorps issus de patients et présentant des réactivités contre des antigènes cardiaques a été réalisée sur des lignées de cardiomyocytes et dans un modèle de sphéroïdes cardiaques. Chez les patients atteints de mélanome et développant des toxicités, une faible expression de molécules inhibitrices (FcγRIIB, CD85j et LAIR-1) à la surface des lymphocytes B périphériques a été observé. Par ailleurs, les lymphocytes B issus de patients atteints de cancer du poumon et développant des toxicités présentent une forte expression du marqueur d'activation CD95 et de re-circulation CXCR5. D'autre part, un enrichissement en populations de lymphocytes B hautement différenciées et activées a été identifié avant l'initiation du traitement chez les patients ayant développé des toxicités. De plus, nous avons identifié chez des patients présentant des toxicités des titres élevés d'auto-anticorps. Ces auto-anticorps peuvent être dirigés contre des autoantigènes cardiaques et musculaires chez des patients atteints de myocardites et/ou myosites. Pour finir, des résultats préliminaires ont permis d'identifier une fixation des auto-anticorps réactifs contre des antigènes cardiaques sur des lignées de cardiomyocytes. Le traitement de sphéroïdes cardiaques avec ces auto-anticorps peut induire une altération de leur contractilité et de la cinétique calcique associée. Nous avons donc mis en évidence une forte activation des lymphocytes B périphériques, associée à une production d'auto-anticorps, chez des patients ayant développé des effets secondaires. Ces résultats soutiennent un rôle potentiel de l'immunité humorale dans les mécanismes sous-jacents à l'émergence d'effets secondaires faisant suite aux immunothérapies anti-checkpoints immunitairesImmune checkpoints inhibitors (ICI) have revolutionized the treatment of previously incurable malignancies. Unfortunately, the use of ICI also induces a bystander breakdown of peripheral tolerance leading to immune related Adverse Events (irAEs) in 30-90% of treated patients, drastically reducing quality of life and requiring therapy dose reduction or discontinuation. As ICI directly target T cells, they have been considered the main culprit for irAEs. Nevertheless, T cells cannot fully explain adverse events, and the role of B cells and their associated mechanisms have not been characterized. We therefore studied the involvement of peripheral B-cell compartment in irAEs, using both phenotypic and functional approaches, in two cohorts of solid cancer patients treated with anti-PD-1 and/or anti-CTLA-4 monoclonal antibodies. Deep phenotyping of B-cell subsets throughout the treatment and at the onset of irAEs has been performed by multi-parametric spectral flow cytometry. Subsequently, to analyze the functions of B-cell subsets, notably their ability to produce antibodies, we set-up a B-cell culture system allowing in vitro differentiation of B cells into antibody-secreting cells. This gave us the opportunity to analyze the antibody production by circulating B cells and their association with irAEs occurence. The screening of circulating B cells phenotype and function was conducted alongside the evaluation of the serum and plasma reactivity of cancer patients by complementary approaches (ELISA, Western Blot, Immunofluorescence assays). We found that, before treatment, patients that develop ICI-induced irAEs exhibit a significantly lower expression on B cell subsets of the FcγRIIB, CD85j and LAIR-1 inhibitory receptors in melanoma patients and higher expression of the CD95 and CXCR5, respectively activating and lymphoid organs re-circulatory markers in lung cancer patients. In addition, increased in baseline abundance of hyper-activated IgD- memory B cell subset or plasmablasts precursor were observed in patients that will undergo irAEs. Moreover, a part of irAEs patients exhibit baseline or ICI-induce circulating autoantibodies which could be directed against the related tissue of irAEs occurrence. Indeed, patients experiencing cardiac/muscular irAEs demonstrated autoantibodies directed against cardiac tissues and well-defined cardiac/muscle antigens. Finally, IgG derived from cardiac/muscular irAEs patients bound to human cardiomyocytes and perturbed the calcium kinetic and the contractibility of cardiac spheroids. These findings highlight a predisposition of irAEs incidence in patients with baseline highly activated and differentiated circulating B cells associated with autoantibody production. Overall, these results support the potential role of the humoral adaptative immunity in the mechanisms of ICI-induced irAEs
Książki na temat "Immune-related adverse effect"
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J, Herzyk Danuta, i Bussiere Jeanine L, red. Immunotoxicology strategies for pharmaceutical safety assessment. Hoboken, N.J: John Wiley & Sons, 2008.
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1929-, Newcombe David S., Rose Noel R i Bloom John C, red. Clinical immunotoxicology. New York: Raven Press, 1992.
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Bussiere, Jeanine L., i Danuta J. Herzyk. Immunotoxicology Strategies for Pharmaceutical Safety Assessment. Wiley & Sons, Incorporated, John, 2008.
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Bussiere, Jeanine L., i Danuta J. Herzyk. Immunotoxicology Strategies for Pharmaceutical Safety Assessment. Wiley & Sons, Incorporated, John, 2008.
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Immunotoxicology Strategies for Pharmaceutical Safety Assessment. Wiley & Sons Canada, Limited, John, 2014.
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Dietert, Rodney R. Immunotoxicity Testing: Methods and Protocols. Humana Press, 2016.
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Coyle, Patricia K. Immune-mediated Disorders of the Central Nervous System. Redaktorzy Emma Ciafaloni, Cheryl Bushnell i Loralei L. Thornburg. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190667351.003.0010.
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This chapter reviews pregnancy in multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and acute transverse myelitis (ATM) syndrome. MS is a major acquired disease of young adults, with a rising female predominance. MS has no direct negative consequences on fertility or pregnancy. Pregnancy has a profound effect on MS, with decrease in disease activity during the last trimester counteracted by a three-month postpartum increase in disease activity. With the development of disease-modifying therapies, important questions arise about washout periods, the feasibility and risks of treating during pregnancy and breastfeeding, and the potential of treatment-related adverse fetal effects. Fortunately, there is good information to counsel women with MS. Neuromyelitis Optica Spectrum Disorder (NMOSD) is a neuroimmune channelopathy. It is a distinct disorder from MS. NMOSD disease activity is not favorably affected by pregnancy. The postpartum period has real risk for disabling attacks. This influences recommendations about breastfeeding and how quickly to resume therapy postpartum. Acute transverse myelitis (ATM) syndrome can occur in both MS and NMOSD but can also be due to other disorders. Workup and treatment of ATM during pregnancy is reviewed, as well as implications for delivery.
Części książek na temat "Immune-related adverse effect"
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Agolti, Mariela, i Lucrecia Solari. "Review of F-18 FDG PET/CT in Evaluating Response to Immunotherapy Treatment". W Beyond Becquerel and Biology to Precision Radiomolecular Oncology: Festschrift in Honor of Richard P. Baum, 11–29. Cham: Springer International Publishing, 2024. http://dx.doi.org/10.1007/978-3-031-33533-4_2.
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AbstractIntroduction: Immunotherapy is a wide-spreading therapeutic resource in oncology. The therapy is guided to improve the patient’s immune response to cancer cells, on the basis of the concept of immune surveillance by activating both cell-mediated and humoral immunity to fight cancer. Immunomodulatory monoclonal antibody therapy utilizes preformed monoclonal antibodies directed against molecular targets to regulate T-cell activation. There are three mechanisms involved in this kind of therapy: antibodies directed against the programmed death protein 1 (PD-1)/programmed death receptor ligand 1 (PD-L1), such as nivolumab and CTLA-4 inhibitors that prevent inhibition of the activated T-cells.Material and Method: Different reveiw articles were reviewed to understand the differences in response assessment of immunotherapy as compared to conventional chemotherapy or radiotherapy when using F-18 FDG PET/CT.Results: When using FDG PET/CT for response assessment, following important items should be considered: (1) Pseudoprogression: meaning that we can see transient enlargement of tumors or the appearance of new tumors followed by tumor shrinkage or long-term stability of tumor size. (2) Hyperprogression which is characterized by rapid increase in tumor burden (more than 50% increase compared to basal) and also time to treatment failure less than 2 months and more than 2 times increase in tumor growth rate, with deteriorating clinical condition. (3) Response to treatment is generally slower than with conventional cytotoxic chemotherapy. (4) Adverse effects (irAE) that are more easily diagnosed through FDG PET CT, than through conventional CT, and the importance of being able to recognize and report them sometimes life-threatening like pneumonitis or colitis. Also nuclear medicine physician should report inflammatory changes like drug induced sarcoid-like lymph nodes and differentiate from progression disease or splenic/liver SUV, moreover keeping in mind that there is evidence of good association between the presence of irAE and good answer to treatment. (5) Evolution of irAE comparing the actual PET with previous reporting the change in 18FDG uptake.Conclusion: Reporting of F-18 FDG PET/CT after immunotherapy, should consider these different items: Pseudoprogression, hyperprogression, irAE, evolution of irAE, and other inflammatory signs related to immunotherapy to improve our methodology efficiency.
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Saccardi, Riccardo, i Fermin Sanchez-Guijo. "How Can Accreditation Bodies, Such as JACIE or FACT, Support Centres in Getting Qualified?" W The EBMT/EHA CAR-T Cell Handbook, 199–201. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-94353-0_38.
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AbstractThe FACT-JACIE accreditation system is based on a standard-driven process covering all the steps of HSC transplant activity, from donor selection to clinical care. Since the first approval of the First Edition of the Standards in 1998, over 360 HSCT programmes or facilities have been accredited at least once, most of them achieving subsequent re-accreditations (Snowden et al. 2017). The positive impact of the accreditation process in the EBMT Registry has been well established (Gratwohl et al. 2014). Starting with version 6.1, the standards include new items specifically developed for other cellular therapy products, with special reference to immune effector cells (IECs). This reflects the rapid evolution of the field of cellular therapy, primarily (but not exclusively) through the use of genetically modified cells, such as CAR-T cells. FACT-JACIE standards cover a wide range of important aspects that can be of use for centres that aim to be accredited in their countries to provide IEC therapy. Notably, FACT-JACIE accreditation itself is a key (or even a prerequisite) condition in some countries for approval by health authorities to provide commercial CAR-T cell therapy and is also valued by pharmaceutical companies (both those developing clinical trials and those manufacturing commercial products), which also inspect the cell therapy programmes and facilities established at each centre (Yakoub-Agha et al. 2020). Interest in applying for FACT-JACIE accreditation that includes IEC therapeutic programmes is clearly increasing, from four applications in 2017 to 36 applications approved in 2019. The standards do not cover the manufacturing of such cells but include the chain of responsibilities when the product is provided by a third party (Maus and Nikiforow 2017). In any case, all the steps in the process in which the centre is involved (e.g., patient or donor evaluations, cell collection, cell reception, and storage) are covered by the standards, including the appropriate agreements with the internal partners, including the pharmacy department. In addition, from a clinical perspective, IECs may require special safety monitoring systems due to the high frequency of acute adverse events related to the massive immunological reaction against the tumour. Although examples and explanations are found in the standard manual, here, the special importance of identifying and managing cytokine release syndrome (CRS) should be emphasized, and the standards focus not on specific therapeutic algorithms but on ensuring that medical and nursing teams are sufficiently trained in the early detection of this and other potential complications (e.g., neurological complications). They also pay attention to the full-time availability within the institution and its pharmacy of the necessary medication to address complications and the capacitation and involvement of Intensive Care and Neurology Department professionals to provide urgent care if needed. Forthcoming cellular therapy products, currently under investigation, will show a wider range of risk profiles, therefore requiring product-specific risk assessment and consequent adaptation of the clinical procedures for different classes of products. The FACT-JACIE standards will continue to adapt to these future needs to assist centres in their achievement of optimal clinical outcomes.
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Bhattacharyya, Joya, i Arthur Kaser. "Immune disorders of the gastrointestinal tract". W Oxford Textbook of Medicine, redaktor Jack Satsangi, 2783–96. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198746690.003.0292.
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Immune homeostasis in the gut is the result of a delicate balance between peaceful coexistence with commensal microbiota, immunomodulatory effects of dietary antigens, and appropriate responses to pathogens. Immune disorders of the gut arise when defects in the integrity of these components lead to a dysregulated immune response to the commensal environment. Primary immunodeficiency syndromes can present with intestinal inflammation but are commonly characterized by an increased susceptibility to infections in childhood. Secondary immunodeficiency can occur in a protein-losing enteropathy where loss of immunoglobulins and lymphocytes increase susceptibility to infections, or as a result of metabolic diseases (e.g. diabetes or liver cirrhosis), infections (e.g. HIV), or drugs (e.g. chemotherapy). Immunosuppressive medication can not only lead to secondary immunodeficiency but in the context of neutropenia, cytotoxic gastrointestinal mucosal injury can lead to neutropenic typhlitis. Graft-versus-host disease arises from host antigen-presenting cells engaging with donor T cells and triggering an inflammatory cascade. Immunotherapy with checkpoint inhibitors can have significant gastrointestinal immune-related adverse effects, most notably enterocolitis. Autoimmune diseases can impact gastrointestinal function. Autoimmune dysautonomia can result in gastrointestinal-specific dysmotility and systemic IgG4-related disease can lead to autoimmune pancreatitis. Systemic autoimmune diseases can have gastrointestinal manifestations related to the primary autoimmune process or as an adverse effect of treatment. Hypersensitivity reactions to dietary antigens (e.g. peanuts) result in food allergies and can be either IgE or non-IgE mediated. Food intolerance which is not immunologically mediated is the result of pharmacological (e.g. monosodium glutamate), enzyme-related (e.g. lactose intolerance), or noncoeliac gluten sensitivity. Eosinophilic gastrointestinal tract disorders are often associated with a food allergen: treatment is with steroids and avoidance of the allergen.
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Davicino, Roberto C., i Claudia Anesini. "Immunomodulatory Plant Extracts and their Compounds. Evaluation of your Safety". W Advanced Pharmacy, 197–224. BENTHAM SCIENCE PUBLISHERS, 2023. http://dx.doi.org/10.2174/9789815049428123010010.
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Medicinal herbs have been in use for the management of human health, for prevention. as well as for the cure of human diseases since ancient civilizations. In recent times, the use of herbal drugs has increased in both developed and developing countries, because of the large chemical, pharmacological, and clinical knowledge of plant drugs and their derivatives, the development of new analytical methods for quality control, the development of new forms of preparation and administration of plant drugs and their derivatives and finally the relatively wide therapeutic margins with less frequent adverse effects. However, naturals are not a synonym for innocuous as many adverse effects can occur. In this regard, there are different levels of perceptions about the safety of medicinal herbs, varying from “completely safe” to “completely harmful”, although there is also a clear idea about its side effects depending on factors such as dosage, characteristics of the plant material and consumer-related factors. Because of this, medicinal plants need to be studied and effective and innocuous doses must be established. Nowadays, immunomodulatory drugs have gained a main role principally as a consequence of COVID-19 produced by the SARS-CoV-2 virus. Some South American plants frequently used in Argentine folk medicine such as Larrea divaricata and Ilex paraguariensis and others used all over the world like Tilia spp. and Coffeea Arabica are known to exert immune-enhancing effects. In this review, we discussed some reports about the immunological effect of the mentioned plants and their majority compounds, focusing on their efficacy and safety.
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Burton, Rosie, i Ana Houston. "HIV medicine". W Oxford Handbook of Tropical Medicine 5e, 69–142. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198810858.003.0003.
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Epidemiology, Virology and immunology, infection, Antiretroviral therapy, opportunistic infections, Antiretroviral drugs, doses and adverse effects, viral failure, Common clinical problems in HIV, HIV-related malignancy, Immune Reconstitution Inflammatory Syndrome (IRIS), HIV prevention strategies, Prevention of mother to child transmission (PMTCT), Post-exposure prophylaxis
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Rivera-Grana, Erick, i Stephanie M. Llop. "Immunotherapy-Associated Uveitis". W Eye Diseases - Recent Advances, New Perspectives and Therapeutic Options [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.106442.
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Novel immunotherapies used to treat some cancers, such as checkpoint inhibitors and target therapies of B-RAF protooncogene and mitogen-activated protein kinase (BRAF/MEK), have been strongly associated with adverse events related to immune dysregulation. These effects are known as immune-related adverse events (irAEs). Uveitis is among the known irAEs, and it occurs in approximately 1% of patients using these therapies. The uveitis observed in these patients ranges from anterior, intermediate, to panuveitis. If irAEs are severe, current recommendations are to stop immunotherapy treatment and simultaneously treat the uveitis with steroids (local or systemic). These oncologic immunotherapies have proved to show positive results in cancer treatment. Their use has increased with time, showing ocular side effects that were not reported previously. It is important that ophthalmologists and non-ophthalmologists are aware of these agents and their potential ocular side effects for timely diagnosis and adequate management. This chapter will review different immunotherapies and their potential ocular manifestations and how to diagnose, monitor, and manage these patients.
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Patel, Anush, Haisam Abid i Amrat Kumar. "The Endocrinological Side Effects of Immunotherapies". W Advances in Precision Medicine Oncology. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.96491.
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The use of immunotherapies is gaining importance in the treatment of advanced malignancies. There are many checkpoints in the immune system which prevents T-cells from attacking one’s own body cells. The cancer cells can camouflage from the T-cells and the immune system is unable to mount an effective anti-tumor response. The immunotherapies, mainly monoclonal antibodies anti-cytotoxic T-lymphocyte antigen 4 (CTLA-4), anti-programmed cell death protein-1 (PD-1) and anti-PD-1 ligand molecules (PD-L1 and L2) reactivate the immune system to act against cancerous cells but they can also cause T-cells to attack healthy cells causing various autoimmune diseases, which are known as immune related adverse events (irAEs). Current clinical data shows increased incidence of pituitary disorders with CTLA4 inhibitors and thyroid dysfunction in patients with PD-1/PD L-1 1 blockade. There have also been association of type 1 diabetes mellitus and primary adrenal insufficiency in patients with immune check point inhibitors. In this chapter we will discuss the incidence, characteristic findings, diagnosis and management of various endocrinological side effects due to targeted immunotherapies used in various malignancies.
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Strobel, Stephan, i Carina Venter. "Immune regulation, food allergies, and food intolerance". W Human Nutrition. Oxford University Press, 2023. http://dx.doi.org/10.1093/hesc/9780198866657.003.0032.
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This chapter details features of the immune system before exploring the relationships between nutrition, immunodeficiencies, and interactions between micronutrient status and immunity. It then discusses major aspects of the immune system and its regulation with particular reference to food allergies and food intolerance. Specific receptors provide interfaces between integrated defence systems and the relationships between innate and adaptive immunity. The chapter considers the effects of malnutrition and obesity to examime the relevance of immune function and public health outcomes. It then examines the nutritional strategies related to the prevention, diagnosis, and management of adverse reactions to food.
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Memis Bilgin, Yavuz. "Clinical Effects and Possible Mechanisms of Transfusion-Related Immunomodulation". W Blood Donation and Transfusion [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.107228.
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Allogeneic blood components are commonly transfused in trauma, surgery, and intensive care units and are related with adverse effects, such as postoperative infections, multi-organ failure, and mortality. The adverse effects of blood transfusions on the immune system are called as transfusion-related immunomodulation (TRIM). Many clinical trials are conducted to show the clinical effects of TRIM. They found in different clinical settings controversial results. There are many possible mechanisms of TRIM. Although until now, the exact mechanisms are not elucidated resulting in a challenge to unravel this complex interaction between immunomodulation and clinical events leading to morbidity and mortality. It has been postulated that allogeneic leukocytes are associated with the clinical adverse effects of TRIM that predominantly is observed in high-risk patients as cardiovascular surgery. Allogeneic leukocytes could activate inflammation cascade leading to adverse events in high-risk patients. Also other blood components as red cells, plasma, and platelets can play a role in the development of inflammatory complications after blood transfusions. In this review, we will discuss the clinical effects and the possible mechanisms of TRIM in relation with allogeneic leukocytes and mediators derived from allogeneic blood transfusions.
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Moran, Carla. "Endocrine Complications of Biological Cancer Therapies". W Oxford Textbook of Endocrinology and Diabetes 3e, redaktorzy John A. H. Wass, Wiebke Arlt i Robert K. Semple, 1774–78. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198870197.003.0218.
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In recent years, modulation of cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death protein 1 (PD-1) pathways has resulted in significant improvements in cancer outcomes. Immune-related adverse events (IrAEs), including endocrinopathies, are common toxicities associated with use of these immune checkpoint inhibitors, with agents affecting the CTLA-4 pathway typically causing hypophysitis, and those affecting the PD-1 pathway most commonly causing thyroid dysfunction. Notably, due to non-specific and ill-defined symptoms, these endocrine-associated IrAEs can escape detection, such that surveillance for these side effects is warranted. Although these endocrinopathies may be irreversible, they are rarely life-threatening and there is emerging evidence that individuals experiencing such side effects have better cancer outcomes. With likely increasing use of these agents over the coming decade, endocrinologists can expect to diagnose and manage these side effects more frequently.
Streszczenia konferencji na temat "Immune-related adverse effect"
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Yenepalli, A., L. Luna Diaz i L. Eggert. "Asthma as an Immune-Related Adverse Effect of Pembrolizumab". W American Thoracic Society 2024 International Conference, May 17-22, 2024 - San Diego, CA. American Thoracic Society, 2024. http://dx.doi.org/10.1164/ajrccm-conference.2024.209.1_meetingabstracts.a5300.
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Vitek, Grace, i Harjot Hansra. "Two Cases of Anti-PD1 Antibody Associated Neurological Immune-Related Adverse Effects (P5-4.001)". W 2023 Annual Meeting Abstracts. Lippincott Williams & Wilkins, 2023. http://dx.doi.org/10.1212/wnl.0000000000203811.
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Richter, M. D., C. S. Crowson, L. A. Kottschade, H. D. Finnes, S. N. Markovic i U. Thanarajasingam. "SAT0588 Rheumatologic immune-related adverse effects of checkpoint inhibitor therapy: a single centrecohort of 29 patients". W Annual European Congress of Rheumatology, EULAR 2018, Amsterdam, 13–16 June 2018. BMJ Publishing Group Ltd and European League Against Rheumatism, 2018. http://dx.doi.org/10.1136/annrheumdis-2018-eular.2645.
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Kandolf Sekulović, Lidija. "TOXICITIES OF TARGETED THERAPY AND IMMUNE-RELATED ADVERSE DRUG REACTIONS OF IMMUNOTHERAPY IN THE TREATMENT OF METASTATIC MELANOMA". W Okrugli sto s međunarodnim učešćem "Melanom". Akademija nauka i umjetnosti Bosne i Hercegovine, 2018. http://dx.doi.org/10.5644/pi2019.180.04.
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Targeted therapy and immunotherapy changed the treatment landscape for metastatic melanoma, which is chemotherapy resistant cancer. In pre-innovation era, the overall survival of patients with metastatic melanoma was 6 months, while today 5-year overall survival rate of 34% (and 50% in good prognostic groups) is evident. However, both treatments have their side effects, and cutaneous are the most frequent. Treating physicians in oncology centres, but also primary care specialists, need to be aware of their spectrum which differs for each class of drug: BRAF inhibitors, MEK inhibitors and immunotherapy with anti-PD1 and anti-CTLA4. While BRAF inhibitors have the most prominent adverse effects which are class specific, there are also drug-specific adverse effects. For example, vemurafenib causes photosensitivity, which is not specific for dabrafenib, while dabrafenib induces pyrexia, that occurs much less frequently with other BRAF inhibitors. Cutaneous rash and cutaneous neoplasms which develop due to paradoxical activation of RAS signalling are described with BRAF inhibitor monotherapy. These side-effects are much less common in combination therapy with BRAF and MEK inhibitor, but MEK inhibitor itself causes characteristic acneiform eruption, and serous retinopathy. Immune related adverse drug reactions are a hallmark of the immune checkpoint inhibitor immunotherapy, which can affect every organ system, and most commonly skin, lungs and gastrointestinal system, with differential frequencies recorded with anti-CTLA4 therapy and anti PD-1 therapy. Skin reactions most frequently include pruritus and eczematous reactions, as well as vitiligo-like hypopigmentation, which is linked Melanom 45 to the better response to treatment. In this review, frequent and rare side effects are presented, as well as the current algorithms for their treatment.
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Sklodowski, Kamil, Vito Dozio, Roberta Poli, Andrés Lanzós, Silvia Lopez-Lastra, Kristina Beeler i Emanuela Romano. "Abstract 1615: Immune-related adverse effects (irAEs) associated proteomic profile in late-stage NSCLC patients after PD-1 blockade". W Proceedings: AACR Annual Meeting 2021; April 10-15, 2021 and May 17-21, 2021; Philadelphia, PA. American Association for Cancer Research, 2021. http://dx.doi.org/10.1158/1538-7445.am2021-1615.
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Kostine, M., E. Mauric, L. Rouxel, T. Barnetche, R. Veillon, F. Martin, C. Dutriaux i in. "OP0088 Immune-related adverse events of cancer immunotherapy – when inflammatory side effects are associated with survival: a single-centre prospective cohort study". W Annual European Congress of Rheumatology, EULAR 2018, Amsterdam, 13–16 June 2018. BMJ Publishing Group Ltd and European League Against Rheumatism, 2018. http://dx.doi.org/10.1136/annrheumdis-2018-eular.3783.
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MONBRUN, Mathilde, Léo Grassion, Elodie Blanchard, Rémi Veillon, Maeva Zysman i Chantal Raherison. "Influenza and Pneumococcal vaccination effects on the immune-related adverse events in patients under immunotherapy for an advanced stage non-small cell lung cancer". W ERS International Congress 2021 abstracts. European Respiratory Society, 2021. http://dx.doi.org/10.1183/13993003.congress-2021.pa2303.
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Barreto, Everton Rodrigo, Rosana Maria Faria Vador i Thalita Martins Ferraz Meneses. "Nurse performance in viral oncolytic therapy". W III SEVEN INTERNATIONAL MULTIDISCIPLINARY CONGRESS. Seven Congress, 2023. http://dx.doi.org/10.56238/seveniiimulti2023-084.
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Introduction: Viral oncolytic therapy (VOT) is an emerging approach in cancer treatment, which is based on the selective replication of a viral vector inside cancer cells, triggering the death of tumor cells by lysis and the spread of new viral particles to the remaining adjacent malignant cells. However, special care is needed from nurses to manage immune-mediated side effects and provide support and education to patients and their families during treatment. Objectives: To survey the nurse's performance in the face of VOT; propose a model of Systematization of Nursing Care (SNC) with the main nursing diagnoses related to VOT. Methods: This is a qualitative literature review, using as a primary source of research the databases - CAPES, PubMed, Scielo, BVS. Composing a sample of 39 articles relevant to the formulation of this article. Results: Although there is a significant scientific production on nursing care in the oncological context, there are still few studies that specifically address the SNC related to TOV and immunotherapies. In view of this and considering and need to fill this gap, an SNC model is proposed, considering the oncologic patient in the face of a holistic view. Regarding the adverse reactions associated with therapy, it is of paramount importance, and the implementation of SNC as a structured care process can contribute significantly to the excellence of care for cancer patients undergoing this innovative therapy, with the main nursing diagnoses related to OVT Conclusion: The integration of scientific knowledge, clinical skills and a humanized approach strengthens the role of nurses as a fundamental part of the multidisciplinary team in the treatment of cancer through OVT.