Diferencia entre revisiones de «Oncologic therapy related adverse events»
| Línea 58: | Línea 58: | ||
==Small molecule inhibitors== | ==Small molecule inhibitors== | ||
===Enasidenib (IDHIFA)=== | ===Enasidenib (IDHIFA)=== | ||
Adverse Events: | |||
*[[Jaundice|Indirect hyperbilirubinemia]] | *[[Jaundice|Indirect hyperbilirubinemia]] | ||
*[[Differentiation syndrome]] | *[[Differentiation syndrome]] | ||
| Línea 63: | Línea 64: | ||
===Ivosidenib (Tibsovo)=== | ===Ivosidenib (Tibsovo)=== | ||
Adverse events | |||
*[[QT prolongation]] | *[[QT prolongation]] | ||
*[[Leukocytosis]] | *[[Leukocytosis]] | ||
| Línea 69: | Línea 70: | ||
===Midostaurin (Rydapt)=== | ===Midostaurin (Rydapt)=== | ||
Adverse Events: | |||
*[[Adverse Events]] | *[[Adverse Events]] | ||
**[[Febrile neutropenia]] | **[[Febrile neutropenia]] | ||
| Línea 79: | Línea 81: | ||
===Nilotinib (Tasigna)=== | ===Nilotinib (Tasigna)=== | ||
Adverse events | |||
*[[QT prolongation]] | |||
*Sudden death | |||
*Myelosuppression | |||
*[[Arterial thrombosis]] | |||
*[[Pancreatitis]] | |||
*[[Hepatotoxicity]] | |||
===Bosutinib (Bosulif)=== | ===Bosutinib (Bosulif)=== | ||
Adverse Events: | |||
*Myelosuppression | *Myelosuppression | ||
*[[Diarrhea]] | *[[Diarrhea]] | ||
| Línea 98: | Línea 100: | ||
===Ibrutinib (Imbruvica)=== | ===Ibrutinib (Imbruvica)=== | ||
Adverse Events: | |||
*[[Cytopenia|Cytopenias]] | *[[Cytopenia|Cytopenias]] | ||
*[[Hypertension]] | *[[Hypertension]] | ||
| Línea 103: | Línea 106: | ||
===Acalabrutinib (Calquence)=== | ===Acalabrutinib (Calquence)=== | ||
Adverse Events: | |||
*[[Headache]] | *[[Headache]] | ||
*[[Diarrhea]] | *[[Diarrhea]] | ||
| Línea 126: | Línea 130: | ||
===Panobinostat lactate (Farydak)=== | ===Panobinostat lactate (Farydak)=== | ||
Adverse Events: | |||
*[[Cytopenia]] | *[[Cytopenia]] | ||
*[[Diarrhea]] | *[[Diarrhea]] | ||
| Línea 131: | Línea 136: | ||
===Ixazomib citrate (Ninlaro)=== | ===Ixazomib citrate (Ninlaro)=== | ||
Adverse Events: | |||
*[[Cytopenias]] | *[[Cytopenias]] | ||
*[[Vomiting]] | *[[Vomiting]] | ||
| Línea 140: | Línea 146: | ||
===Venetoclax (Venclexta)=== | ===Venetoclax (Venclexta)=== | ||
Adverse Events: | |||
*[[Tumor lysis syndrome]] | *[[Tumor lysis syndrome]] | ||
*Bone marrow suppression | *Bone marrow suppression | ||
Revisión del 18:07 6 mar 2020
Background
Many of the oncologic therapies currently employed involved immune system checkpoint inhibition which allow for improvement of T-cell activation towards cancer cells. This boost to the immune system can occur by many mechanisms that encompass the list of "novel" oncologic agents" described below.[1]
Clinical Features
- Many novel oncologic therapies and Biologic immunomodulators adverse reactions may mimic common ED presentations such as sepsis.
Types of novel oncologic agents
- Genetically engineered T cells
- CD19–chimeric antigen receptor (CAR)-T cell therapy
- Monoclonal Antibodies against PD-1 checkpoints
- Small-molecule inhibitors
- Monoclonal antibodies against cell surface antigens
- Antibody-drug conjugates
- Immunotoxins
- Bispecific T-cell engagers
Differential Diagnosis
- Decreased cellular immunity which an cause reactivation or new
- Neurologic syndromes
- Hematologic side effects
- Cardiac effects
- Allergic reactions
- Pulmonary
- Endocrine
- GI
- Perforations
- Clostridium difficile
- Acute bacterial infections
- Malignancies
- Non-melanoma skin cancers
- Lymphoma
CAR-T cells medications
Tisagenlecleucel (Kymriah)
- Indications:
- Acute lymphoblastic leukemia
- Large B-cell lymphoma
- Adverse events include:
Axicabtagene ciloleucel (Yescarta)
- Indications:
- Acute lymphoblastic leukemia
- Large B-cell lymphoma
- Adverse events include:
- Cytokine release syndrome
- Pancytopenia
- Altered mental status
PD1 Monoclonal Antibodies
Pembrolizumab (Keytruda)
- A PD-1 humanized mouse mAb
- Adverse events include:
- Infusion reactions
- Musculoskeletal pain
- Dyspnea
- Diarrhea
- Arrhythmias
- Myocardial infarctions
- Pericardial effusions
Nivolumab (OPDIVO)
- A PD-1 human IgG4 mAb
- Adverse events include:
Small molecule inhibitors
Enasidenib (IDHIFA)
Adverse Events:
Ivosidenib (Tibsovo)
Adverse events
Midostaurin (Rydapt)
Adverse Events:
Nilotinib (Tasigna)
Adverse events
- QT prolongation
- Sudden death
- Myelosuppression
- Arterial thrombosis
- Pancreatitis
- Hepatotoxicity
Bosutinib (Bosulif)
Adverse Events:
- Myelosuppression
- Diarrhea
- Pancreatitis
- Hepatotoxicity
- Cardiac arrest
- Arrythmia
- ACS
Ibrutinib (Imbruvica)
Adverse Events:
Acalabrutinib (Calquence)
Adverse Events:
Duvelisib (Copiktra)
Copanlisib (Aliqopa)
Panobinostat lactate (Farydak)
Adverse Events:
Ixazomib citrate (Ninlaro)
Adverse Events:
Venetoclax (Venclexta)
Adverse Events:
- Tumor lysis syndrome
- Bone marrow suppression
- Autoimmune hemolytic anemia
Monoclonal antibodies against cell surface antigens
Ofatumumab (Arzerra)
Obinutuzumab (Gazyva)
Daratumumab (Darzalex)
Elotuzumab (Empliciti)
Empliciti (Poteligeo)
Antibody-drug conjugates
Inotuzumab ozogamicin (Besponsa)
Gemtuzumab ozogamicin (Mylotarg)
Brentuximab vedotin (Adcetris)
Immunotoxin
Moxetumomab pasudotox-tdfk (Lumoxiti)
Bispecific T-cell engager (Blincyto)
Blinatumomab
Management
Disposition
See Also
External Links
References
- ↑ Shah, M., Rajha, E., DiNardo, C., Muckey, E., Wierda, W. G., & Yeung, S. C. J. (2020). Adverse Events of Novel Therapies for Hematologic Malignancies: What Emergency Physicians Should Know. Annals of Emergency Medicine, 75(2), 264–286. https://doi.org/10.1016/j.annemergmed.2019.07.015