Immune-related adverse events with immune checkpoint inhibitors in thoracic malignancies: focusing on non-small cell lung cancer patients

Abstract

Immune checkpoint inhibitors (ICIs) have revolutionized treatment landscape among non-small cell lung cancer (NSCLC) patients in first- and second-line setting, and may become soon new treatment options in other thoracic malignancies such as small cell lung cancer (SCLC) or mesothelioma. The use of these drugs has indubitably changed the toxicity profile the oncologists are familiar with, and new spectra of immune-related adverse events are being reported with the widespread use of immunotherapies in solid tumors. Clinical management and understanding of immune-related adverse events is new and complex but expertise is still limited. In this review, we are summarizing the incidence and management of main side effects related to ICIs focusing on NSCLC patients.

Keywords: Immune-related; adverse events; non-small cell lung cancer (NSCLC).

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1

Spectrum of toxicity of ICIs (from Champiat et al. with permission of Annals of Oncology). ICI, immune checkpoint inhibitor.

Figure 2

Median time to onset immune-related adverse events for different toxicities with anti-PD-1 (nivolumab) in NSCLC patients. Circles represent medians; bars signify ranges. Inf. reaction, infusion reaction or hypersensitivity; NSCLC, non-small cell lung cancer.

Figure 3

The five pillars of immunotherapy toxicity management (from Champiat et al. with permission of Ann of Oncology).