scholarly journals Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immune effector cell-related adverse events

2020 ◽  
Vol 8 (2) ◽  
pp. e001511
Author(s):  
Marcela V Maus ◽  
Sara Alexander ◽  
Michael R Bishop ◽  
Jennifer N Brudno ◽  
Colleen Callahan ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Effector Cell ◽  
Cancer Therapeutics ◽  
Immune Effector Cell ◽  
Cell Therapies ◽  
Immune Effector ◽  
Hematological Cancers ◽  
Immunotherapy Of Cancer

Immune effector cell (IEC) therapies offer durable and sustained remissions in significant numbers of patients with hematological cancers. While these unique immunotherapies have improved outcomes for pediatric and adult patients in a number of disease states, as ‘living drugs,’ their toxicity profiles, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), differ markedly from conventional cancer therapeutics. At the time of article preparation, the US Food and Drug Administration (FDA) has approved tisagenlecleucel, axicabtagene ciloleucel, and brexucabtagene autoleucel, all of which are IEC therapies based on genetically modified T cells engineered to express chimeric antigen receptors (CARs), and additional products are expected to reach marketing authorization soon and to enter clinical development in due course. As IEC therapies, especially CAR T cell therapies, enter more widespread clinical use, there is a need for clear, cohesive recommendations on toxicity management, motivating the Society for Immunotherapy of Cancer (SITC) to convene an expert panel to develop a clinical practice guideline. The panel discussed the recognition and management of common toxicities in the context of IEC treatment, including baseline laboratory parameters for monitoring, timing to onset, and pharmacological interventions, ultimately forming evidence- and consensus-based recommendations to assist medical professionals in decision-making and to improve outcomes for patients.

scholarly journals The Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of acute leukemia

2020 ◽  
Vol 8 (2) ◽  
pp. e000810
Author(s):  
Michael M Boyiadzis ◽  
Ivan Aksentijevich ◽  
Daniel A Arber ◽  
John Barrett ◽  
Renier J Brentjens ◽  
...  
Keyword(s):  
Clinical Practice ◽  
T Cell ◽  
Acute Leukemia ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Hematopoietic Cell Transplantation ◽  
Lymphoblastic Leukemia ◽  
Cell Therapies ◽  
Wide Range ◽  
Immunotherapy Of Cancer

Acute leukemia is a constellation of rapidly progressing diseases that affect a wide range of patients regardless of age or gender. Traditional treatment options for patients with acute leukemia include chemotherapy and hematopoietic cell transplantation. The advent of cancer immunotherapy has had a significant impact on acute leukemia treatment. Novel immunotherapeutic agents including antibody-drug conjugates, bispecific T cell engagers, and chimeric antigen receptor T cell therapies have efficacy and have recently been approved by the US Food and Drug Administration (FDA) for the treatment of patients with acute leukemia. The Society for Immunotherapy of Cancer (SITC) convened a panel of experts to develop a clinical practice guideline composed of consensus recommendations on immunotherapy for the treatment of acute lymphoblastic leukemia and acute myeloid leukemia.

scholarly journals Newly developed pseudogout arthritis after therapy with MAGE-A4 directed TCR T cells responded to treatment with tocilizumab

2021 ◽  
Vol 9 (7) ◽  
pp. e002716
Author(s):  
Sang T. Kim ◽  
Jean Tayar ◽  
Siqing Fu ◽  
Danxia Ke ◽  
Elliot Norry ◽  
...  
Keyword(s):  
T Cells ◽  
Synovial Fluid ◽  
Th17 Cells ◽  
Effector Cell ◽  
Calcium Pyrophosphate ◽  
Calcium Pyrophosphate Dihydrate ◽  
Immune Effector Cell ◽  
Cell Therapies ◽  
Immune Effector ◽  
Pyrophosphate Dihydrate

With durable cancer responses, genetically modified cell therapies are being implemented in various cancers. However, these immune effector cell therapies can cause toxicities, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Pseudogout arthritis is an inflammatory arthritis induced by deposition of calcium pyrophosphate dihydrate crystals. Here, we report a case of pseudogout arthritis in a patient treated with MAGE-A4 directed T cell receptor T cells, for fallopian tube cancer. The patient developed CRS and ICANS 7 days after infusion of the T cells. Concurrently, the patient newly developed sudden onset of left knee arthritis. Synovial fluid analyses revealed the presence of calcium pyrophosphate dihydrate crystal. Notably, the pseudogout arthritis was resolved with tocilizumab, which was administered for the treatment of CRS and ICANS. Immunoprofiling of the synovial fluid showed that the proportion of inflammatory interleukin 17 (IL-17)-producing CD4+ T (Th17) cells and amount of IL-6 were notably increased, suggesting a potential role of Th17 cells in pseudogout arthritis after T-cell therapy. To the best of our knowledge, this is the first reported case of pseudogout arthritis after cell therapy. Clinicians, especially hematologists, oncologists and rheumatologists, should be aware that pseudogout arthritis can be associated with CRS/ICANS.

scholarly journals Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of urothelial cancer

2021 ◽  
Vol 9 (7) ◽  
pp. e002552
Author(s):  
Matthew D Galsky ◽  
Arjun V Balar ◽  
Peter C Black ◽  
Matthew T Campbell ◽  
Gail S Dykstra ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Patient Outcomes ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Urothelial Cancer ◽  
Diagnostic Testing ◽  
Care Providers ◽  
Immunotherapy Of Cancer ◽  
Selection Of

A number of immunotherapies have been developed and adopted for the treatment of urothelial cancer (encompassing cancers arising from the bladder, urethra, or renal pelvis). For these immunotherapies to positively impact patient outcomes, optimal selection of agents and treatment scheduling, especially in conjunction with existing treatment paradigms, is paramount. Immunotherapies also warrant specific and unique considerations regarding patient management, emphasizing both the prompt identification and treatment of potential toxicities. In order to address these issues, the Society for Immunotherapy of Cancer (SITC) convened a panel of experts in the field of immunotherapy for urothelial cancer. The expert panel developed this clinical practice guideline (CPG) to inform healthcare professionals on important aspects of immunotherapeutic treatment for urothelial cancer, including diagnostic testing, treatment planning, immune-related adverse events (irAEs), and patient quality of life (QOL) considerations. The evidence- and consensus-based recommendations in this CPG are intended to give guidance to cancer care providers treating patients with urothelial cancer.

scholarly journals Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of lymphoma

2020 ◽  
Vol 8 (2) ◽  
pp. e001235
Author(s):  
Sattva S Neelapu ◽  
Sherry Adkins ◽  
Stephen M Ansell ◽  
Joshua Brody ◽  
Mitchell S Cairo ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Patient Outcomes ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Healthcare Professionals ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Clinical Implementation ◽  
Non Hodgkin Lymphoma ◽  
Immunotherapy Of Cancer

The recent development and clinical implementation of novel immunotherapies for the treatment of Hodgkin and non-Hodgkin lymphoma have improved patient outcomes across subgroups. The rapid introduction of immunotherapeutic agents into the clinic, however, has presented significant questions regarding optimal treatment scheduling around existing chemotherapy/radiation options, as well as a need for improved understanding of how to properly manage patients and recognize toxicities. To address these challenges, the Society for Immunotherapy of Cancer (SITC) convened a panel of experts in lymphoma to develop a clinical practice guideline for the education of healthcare professionals on various aspects of immunotherapeutic treatment. The panel discussed subjects including treatment scheduling, immune-related adverse events (irAEs), and the integration of immunotherapy and stem cell transplant to form recommendations to guide healthcare professionals treating patients with lymphoma.

scholarly journals Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of breast cancer

2021 ◽  
Vol 9 (8) ◽  
pp. e002597
Author(s):  
Leisha A Emens ◽  
Sylvia Adams ◽  
Ashley Cimino-Mathews ◽  
Mary L Disis ◽  
Margaret E Gatti-Mays ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Checkpoint Inhibitors ◽  
Diagnostic Testing ◽  
Progression Free Survival ◽  
The United States ◽  
Care Providers ◽  
Immunotherapy Of Cancer

Breast cancer has historically been a disease for which immunotherapy was largely unavailable. Recently, the use of immune checkpoint inhibitors (ICIs) in combination with chemotherapy for the treatment of advanced/metastatic triple-negative breast cancer (TNBC) has demonstrated efficacy, including longer progression-free survival and increased overall survival in subsets of patients. Based on clinical benefit in randomized trials, ICIs in combination with chemotherapy for the treatment of some patients with advanced/metastatic TNBC have been approved by the United States (US) Food and Drug Administration (FDA), expanding options for patients. Ongoing questions remain, however, about the optimal chemotherapy backbone for immunotherapy, appropriate biomarker-based selection of patients for treatment, the optimal strategy for immunotherapy treatment in earlier stage disease, and potential use in histological subtypes other than TNBC. To provide guidance to the oncology community on these and other important concerns, the Society for Immunotherapy of Cancer (SITC) convened a multidisciplinary panel of experts to develop a clinical practice guideline (CPG). The expert panel drew upon the published literature as well as their clinical experience to develop recommendations for healthcare professionals on these important aspects of immunotherapeutic treatment for breast cancer, including diagnostic testing, treatment planning, immune-related adverse events (irAEs), and patient quality of life (QOL) considerations. The evidence-based and consensus-based recommendations in this CPG are intended to give guidance to cancer care providers treating patients with breast cancer.

scholarly journals Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immune checkpoint inhibitor-related adverse events

2021 ◽  
Vol 9 (6) ◽  
pp. e002435
Author(s):  
Julie R Brahmer ◽  
Hamzah Abu-Sbeih ◽  
Paolo Antonio Ascierto ◽  
Jill Brufsky ◽  
Laura C Cappelli ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Adverse Events ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Immune Checkpoint ◽  
Clinical Decision Making ◽  
Checkpoint Inhibitors ◽  
Standard Of Care ◽  
Clinical Decision ◽  
Immunotherapy Of Cancer

Immune checkpoint inhibitors (ICIs) are the standard of care for the treatment of several cancers. While these immunotherapies have improved patient outcomes in many clinical settings, they bring accompanying risks of toxicity, specifically immune-related adverse events (irAEs). There is a need for clear, effective guidelines for the management of irAEs during ICI treatment, motivating the Society for Immunotherapy of Cancer (SITC) to convene an expert panel to develop a clinical practice guideline. The panel discussed the recognition and management of single and combination ICI irAEs and ultimately developed evidence- and consensus-based recommendations to assist medical professionals in clinical decision-making and to improve outcomes for patients.

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