Psychiatric consequences of cancer treatments: therapeutic monoclonal antibodies

2016 ◽  
Author(s):  
Andrew Hodgkiss
Keyword(s):  
Monoclonal Antibodies ◽  
B Lymphocytes ◽  
Immune Checkpoint Inhibitors ◽  
Jc Virus ◽  
Checkpoint Inhibitors ◽  
Cancer Treatments ◽  
Posterior Reversible Encephalopathy ◽  
Neuropsychiatric Toxicity ◽  
Reversible Encephalopathy ◽  
Therapeutic Monoclonal Antibodies

The adverse psychiatric consequences of a range of monoclonal antibodies used to treat cancer are reviewed. Bevacizumab disrupts endothelial function at the blood–brain barrier and can provoke posterior reversible encephalopathy syndrome. The immune checkpoint inhibitors cause autoimmune hypophysitis and thyroiditis with associated psychopathology. Rituximab causes profound immunosuppression of B lymphocytes, and hence can reactivate childhood JC virus infection to cause progressive multifocal leucoencephalopathy. The marked neuropsychiatric toxicity of blinatumomab is described.

scholarly journals Biological bases of cancer immunotherapy

2021 ◽  
Vol 23 ◽  
Author(s):  
Maryanne M. Gonzales Carazas ◽  
Joseph A. Pinto ◽  
Fanny L. Casado
Keyword(s):  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Acquired Resistance ◽  
Historical Review ◽  
Predictive Biomarkers ◽  
High Variability ◽  
Therapeutic Approaches ◽  
Cancer Treatments ◽  
Cancer Types

Abstract Immunotherapy has changed the landscape of cancer treatment and has significantly improved the outcome of several cancer types including breast, lung, colorectal and prostate. Neoantigen recognition and immune checkpoint inhibitors are nowadays the milestones of different immunotherapeutic regimes; however, high cost, primary and acquired resistance and the high variability of responses make their extensive use difficult. The development of better predictive biomarkers that represent tumour diversity shows promise because there is a significant body of clinical data showing a spectrum of immunotherapeutic responses that might be related back to their specific characteristics. This article makes a conceptual and historical review to summarise the main advances in our understanding of the role of the immune system in cancer, while describing the methodological details that have been successfully implemented on cancer treatments and that may hold the key to improved therapeutic approaches.

scholarly journals Immuno-related endocrinopathy in patients treated with immune checkpoint inhibitors

2020 ◽  
pp. 16-24
Author(s):  
D. I. Yudin ◽  
K. K. Laktionov ◽  
K. A. Sarantseva ◽  
O. I. Borisova ◽  
V. V. Breder ◽  
...  
Keyword(s):  
Monoclonal Antibodies ◽  
Clinical Practice ◽  
Adverse Events ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Serious Adverse Events ◽  
Immune Mediated ◽  
Discontinuation Of Treatment ◽  
The Russian Federation

Recently immune checkpoint inhibitors amazingly changed the landscape of cancer therapy worldwide. The number of immune checkpoint molecules in clinical practice is constantly increasing. There are some monoclonal antibodies recently registered in the Russian Federation: anti-PD1 antibodies (nivolumab, pembrolizumab), anti-PD-L1 (atezolizumab, durvalumab), anti-CTLA-4 (ipilimumab). Immune-mediated endocrinopathies are some of the most common complications of immunotherapy. According to the results of clinical studies, the incidence of serious endocrine immuno-mediated adverse events with anti-PD1 monoclonal antibodies is low (3.5–8%). The use of anti-CTLA4 antibodies, combined regimens, and the use of immunotherapy after chemoradiotherapy significantly increase the incidence of serious adverse events to 30%. In clinical practice of N.N. Blokhin Cancer Research Center among 245 non-small cell lung cancer and hepatocellular carcinoma patients treated with immunotherapy, 22 (8,9%) developed an immune-mediated endocrinopathy. Most patients developed adverse events of 1–2 degrees, in two patients – 3 degrees, requiring discontinuation of treatment. The aim of this article was to provide useful information and recommendations regarding the management of common immuno-related endocrine adverse events (including hypothyroidism, hyperthyroidism, pituitary, adrenal insufficiency) for clinical oncologists.

scholarly journals Immune-Mediated Colitis

2019 ◽  
Vol 17 (4) ◽  
pp. 506-523
Author(s):  
Tara Menon ◽  
Anita Afzali
Keyword(s):  
Inflammatory Bowel Disease ◽  
Monoclonal Antibodies ◽  
Immune System ◽  
Immune Checkpoint Inhibitors ◽  
Tumor Response ◽  
Current Knowledge ◽  
Checkpoint Inhibitors ◽  
Immune Mediated ◽  
Wide Range ◽  
Inflammatory Bowel

Abstract Purpose of review This review addresses our current knowledge of immune-mediated colitis (IMC) and offers a practical guide to its management. Recent findings Due to the similarity in clinical, endoscopic, and histologic findings between IMC and inflammatory bowel disease (IBD), gastroenterologists have tailored their approach to IMC management to that of IBD. Summary Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that augment the T-cell anti-tumor response of the immune system and have demonstrated their importance in the treatment of a wide range of malignancies. With the growing benefits of ICIs, there are immune-related adverse events (irAEs) that mirror many known autoimmune diseases. Diarrhea and IMC are the most common and severe irAEs noted. No standardized guidelines exist in the management of these irAEs.

scholarly journals Autoimmune Endocrine Dysfunctions Associated with Cancer Immunotherapies

2019 ◽  
Vol 20 (10) ◽  
pp. 2560 ◽  
Author(s):  
Silvia Martina Ferrari ◽  
Poupak Fallahi ◽  
Giusy Elia ◽  
Francesca Ragusa ◽  
Ilaria Ruffilli ◽  
...  
Keyword(s):  
Monoclonal Antibodies ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Clinical Signs ◽  
Gonadal Hormones ◽  
Thyroid Storm ◽  
Insulin Dependent ◽  
Cancer Immunotherapies ◽  
Thyroid Dysfunctions

Immune checkpoint inhibitors block the checkpoint molecules. Different types of cancer immune checkpoint inhibitors have been approved recently: CTLA-4 monoclonal antibodies (as ipilimumab); anti-PD-1 monoclonal antibodies (as pembrolizumab and nivolumab); and anti-PD-L1 monoclonal antibodies (as atezolizumab, avelumab, and durmalumab). We collect recent published results about autoimmune endocrine dysfunctions associated with cancer antibody immunotherapies. These agents cause a raised immune response leading to immune-related adverse events (irAEs), varying from mild to fatal, based on the organ system and severity. Immune-related endocrine toxicities are usually irreversible in 50% of cases, and include hypophysitis, thyroid dysfunctions, type 1 diabetes mellitus, and adrenal insufficiency. Anti-PD-1-antibodies are more frequently associated with thyroid dysfunctions (including painless thyroiditis, hypothyroidism, thyrotoxicosis, or thyroid storm), while the most frequent irAE related to anti-CTLA-4-antibodies is hypophysitis. The combination of anti-CTLA-4 and anti-PD-1 antibodies is associated with a 30% chance of irAEs. Symptoms and clinical signs vary depending on the target organ. IrAEs are usually managed by an oncological therapist, but in more challenging circumstances (i.e., for new onset insulin–dependent diabetes, hypoadrenalism, gonadal hormones dysfunctions, or durable hypophysitis) an endocrinologist is needed.

Evaluation of tolerability and reactions of immune checkpoint inhibitors.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e14605-e14605 ◽  
Author(s):  
Ozlem Nuray Sever ◽  
Ozlem Sonmez ◽  
Osman Gokhan Demir
Keyword(s):  
Monoclonal Antibodies ◽  
Side Effects ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Treatment Interruption ◽  
Ease Of Use ◽  
Treatment Change ◽  
Function Test ◽  
Cessation Of Treatment

e14605 Background: Immunotherapies have revolutionized the treatment of cancer, especially in recent years. Today, there are anti-CTLA-4 antibodies and PD-L1 monoclonal antibodies which are active in use as checkpoint inhibitors. Side effects of these agents have a different spectrum in the form of immuno-related side effects. Methods: In this study, we aimed to evaluate the side effect and tolerability in patients treated with immune checkpoint inhibitors in our clinic. Results: 32 patients who were treated with PD-L1 monoclonal antibodies between August 2015 and January 2017 were screened retrospectively in our clinic. Six of the cases had immuno-related side effects (18.75%). 2 patients had a elevated liver function test. Both patients were diagnosed with NSCLC. In both of them, elevation was detected in the second course of nivolumab treatment, and the USG and hepatitis markers of the patients were normal. Enzymes returned to normal after treatment interruption. In a patient diagnosed with malignant melanoma that receiving pembrolizumab colitis was developed after 3th cycles of the therapy. The treatment of the patient who recovered after steroid administration and treatment interruption continued until the 8th cure. In the third cure of the patient with NSCLC, when nivolumab was used pneumonitis was diagnosed. Steroid treatment was applied for 2 weeks. Our patient continued to use nivolumab for up to 22 cycles. In our patient with malign melanoma that treated with pembrolizumab autoimmune thyroiditis developed. We started prednisolone treatment. After recovery our patient's treatment continued. In one of our patient who was diagnosed with malign melanoma, after the second cure of the treatment, diffuse edema and shortness of breath due to heart failure was detected. Echocardiography revealed a low ejection fraction. Methylprednisolone was started by cessation of treatment. Control ejection fractions normalized. Conclusions: İmmuno-related side effects were regarded as manageable side effects and no treatment change was needed. Immune Checkpoint inhibitors, which have been shown to be useful for survival every day, are proceeding to take a favorable position in the treatment of cancer with ease of use and lack of side effects.

scholarly journals Current Immunotherapeutic Approaches in T Cell Non-Hodgkin Lymphomas

Cancers ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 339 ◽  
Author(s):  
Teresa Poggio ◽  
Justus Duyster ◽  
Anna Illert
Keyword(s):  
Clinical Trials ◽  
Monoclonal Antibodies ◽  
T Cell ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Tumor Antigens ◽  
Checkpoint Inhibitors ◽  
Cell Physiology ◽  
Cell Therapies ◽  
Car T

T cell non-Hodgkin lymphoma (T-NHL) is a rare and heterogeneous group of neoplasms of the lymphoid system. With the exception of a few relatively indolent entities, T-NHL is typically aggressive, treatment resistant, and associated with poor prognosis. Relatively few options with proven clinical benefit are available for patients with relapsed or refractory disease. Immunotherapy has emerged as a promising treatment for the management of patients with hematological malignancies. The identification of tumor antigens has provided a large number of potential targets. Therefore, several monoclonal antibodies (alemtuzumab, SGN-30, brentuximab vedotin, and mogamulizumab), directed against tumor antigens, have been investigated in different subtypes of T-NHL. In addition to targeting antigens involved in cancer cell physiology, antibodies can stimulate immune effector functions or counteract immunosuppressive mechanisms. Chimeric antigen receptor (CAR)-T cells directed against CD30 and immune checkpoint inhibitors are currently being investigated in clinical trials. In this review, we summarize the currently available clinical evidence for immunotherapy in T-NHL, focusing on the results of clinical trials using first generation monoclonal antibodies, new immunotherapeutic agents, immune checkpoint inhibitors, and CAR-T cell therapies.

scholarly journals Therapeutic Monoclonal Antibodies: Current Perspectives and Applications for the Treatment of Head and Neck Cancer

2011 ◽  
Vol 2 (2) ◽  
pp. 87-94
Author(s):  
Stanislas Blein ◽  
Sam Hou
Keyword(s):  
Monoclonal Antibodies ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Egf Receptor ◽  
The United States ◽  
Cancer Treatments ◽  
Traditional Medicines ◽  
Biotechnology Firms ◽  
Therapeutic Monoclonal Antibodies

ABSTRACT Over the past two decades, monoclonal antibodies have emerged as a versatile class of therapeutics with unique properties. More than 30 therapeutic antibodies are now approved in the United States and European Union, with numerous candidates filling the preclinical and clinical pipeline of every major pharmaceutical companies and biotechnology firms. Monoclonal antibodies have the advantage over traditional medicines in that they are able to specifically bind to the desired targets with little to no associated toxicity. In the recent years, monoclonal antibodies approved for oncology treatments have gained in notoriety and are now used as adjuvants or neo-adjuvants to radiotherapy, chemotherapy and surgery. In the field of head and neck cancer, the anti-EGF receptor antibody Erbitux has paved the way for new targeted treatments to SCCHN. This review introduces some basic concepts and recent perspectives on monoclonal antibodies with a focus on head and neck cancer treatments.

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