Opportunistic infections in patients treated with immunotherapy for cancer
Open Access
- 1 January 2014
- journal article
- Published by BMJ in Journal for ImmunoTherapy of Cancer
- Vol. 2 (1), 19
- https://doi.org/10.1186/2051-1426-2-19
Abstract
Immunomodulatory antibodies that enhance the immune system to fight cancer are revolutionizing the treatment of patients with an expanding variety of malignancies. There is a unique spectrum of side effects associated with immunomodulatory antibodies, termed immune-related adverse events (irAEs), which include colitis and hepatitis among others. The treatment of refractory or severe irAEs can occasionally require significant immunosuppression, involving steroids or tumor necrosis factor-alpha antagonists, placing these patients at risk for infections. We present the first reported case to our knowledge of an opportunistic infection in a patient treated with an immunomodulatory antibody. As the use of immunomodulatory antibodies expands and more patients develop irAEs that require treatment with immunosuppression, recognition of the potential for opportunistic infections in this emerging patient population will be critical. Prospective trials are needed to define the optimal immunosuppressive management of irAEs and determine whether prophylactic antiviral, antibacterial, or antifungal therapies are beneficial in this unique population.This publication has 8 references indexed in Scilit:
- Survival, Durable Tumor Remission, and Long-Term Safety in Patients With Advanced Melanoma Receiving NivolumabJournal of Clinical Oncology, 2014
- Safety, Efficacy, and Biomarkers of Nivolumab With Vaccine in Ipilimumab-Refractory or -Naive MelanomaJournal of Clinical Oncology, 2013
- Safety and Tumor Responses with Lambrolizumab (Anti–PD-1) in MelanomaThe New England Journal of Medicine, 2013
- Management of Immune-Related Adverse Events and Kinetics of Response With IpilimumabJournal of Clinical Oncology, 2012
- Safety, Activity, and Immune Correlates of Anti–PD-1 Antibody in CancerThe New England Journal of Medicine, 2012
- Ipilimumab plus Dacarbazine for Previously Untreated Metastatic MelanomaThe New England Journal of Medicine, 2011
- Improved Survival with Ipilimumab in Patients with Metastatic MelanomaThe New England Journal of Medicine, 2010
- Guidelines for Preventing Infectious Complications among Hematopoietic Cell Transplantation Recipients: A Global PerspectiveTransplantation and Cellular Therapy, 2009