Diferencia entre revisiones de «Oncologic therapy related adverse events»
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==Background== | ==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. | |||
==Clinical Features== | ==Clinical Features== | ||
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*[[Biologic immunomodulators|Monoclonal Antibodies]] against PD-1 checkpoints | *[[Biologic immunomodulators|Monoclonal Antibodies]] against PD-1 checkpoints | ||
*Small-molecule inhibitors | *Small-molecule inhibitors | ||
*Monoclonal antibodies against cell surface antigens | |||
*Antibody-drug conjugates | *Antibody-drug conjugates | ||
*Immunotoxins | *Immunotoxins | ||
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{{oncologic therapy adverse events}} | {{oncologic therapy adverse events}} | ||
==CAR-T cells medications== | ==CAR-T cells medications== | ||
===Tisagenlecleucel (Kymriah)=== | ===Tisagenlecleucel (Kymriah)=== | ||
*Indications: | |||
**Acute lymphoblastic leukemia | |||
**Large B-cell lymphoma | |||
*Adverse events include: | |||
**[[Cytokine release syndrome]] | |||
**[[Hypogammaglobulinemia]] | |||
**[[Pancytopenia]] | |||
**[[Altered mental status]] | |||
===Axicabtagene ciloleucel (Yescarta)=== | ===Axicabtagene ciloleucel (Yescarta)=== | ||
*Indications: Acute lymphoblastic leukemia | *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: | |||
**[[Graft-vs-host disease]] | |||
**[[Portal vein thrombosis]] | |||
==Small molecule inhibitors== | |||
===Enasidenib (IDHIFA)=== | |||
===Ivosidenib (Tibsovo)=== | |||
===Midostaurin (Rydapt)=== | |||
===Nilotinib (Tasigna)=== | |||
===Bosutinib (Bosulif)=== | |||
===Ibrutinib (Imbruvica)=== | |||
===Acalabrutinib (Calquence)=== | |||
===Duvelisib (Copiktra)=== | |||
===Copanlisib (Aliqopa)=== | |||
===Panobinostat lactate (Farydak)=== | |||
===Ixazomib citrate (Ninlaro)=== | |||
===Venetoclax (Venclexta)=== | |||
==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== | ==Management== | ||
Revisión del 21:53 4 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.
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: