Safe anti-programmed cell death-1 rechallenge with antibody switching after immune-related adverse events: brief communication

Immunotherapy ◽  
2021 ◽  
Author(s):  
Francisco Aya ◽  
E Azucena González-Navarro ◽  
Clara Martínez ◽  
Esther Carcelero ◽  
Ana Arance
Keyword(s):  
Cell Death ◽  
Adverse Event ◽  
Programmed Cell Death ◽  
Adverse Events ◽  
Metastatic Melanoma ◽  
Related Adverse Event ◽  
Safe Strategy ◽  
Programmed Cell Death 1 ◽  
Safety Outcomes ◽  
Biological Differences

Aim: To evaluate the safety of rechallenge with a different anti-PD-1 antibody after an immune-related adverse event (irAE) that has prompted the discontinuation of anti-PD-1 therapy. Patients & methods: We describe two patients with metastatic melanoma who developed potentially disabling and early irAEs following anti-PD-1 treatment. Therapy was discontinued and toxicities resolved with corticosteroids. Results: Rechallenge switching to an alternative anti-PD-1 antibody did not lead to a new or recurrent irAE. Conclusion: Switching to a different anti-PD-1 antibody when resuming therapy after an irAE might be a safe strategy and warrants further investigation. Structural and biological differences between antibodies might explain the different safety outcomes.

Bullous pemphigoid, an autoantibody-mediated disease, is a novel immune-related adverse event in patients treated with anti-programmed cell death 1 antibodies

2016 ◽  
Vol 26 (4) ◽  
pp. 413-416 ◽  
Author(s):  
Shelley J.E. Hwang ◽  
Giuliana Carlos ◽  
Shaun Chou ◽  
Deepal Wakade ◽  
Matteo S. Carlino ◽  
...  
Keyword(s):  
Cell Death ◽  
Adverse Event ◽  
Programmed Cell Death ◽  
Bullous Pemphigoid ◽  
Related Adverse Event ◽  
Programmed Cell Death 1

Side effects of immune-checkpoint inhibitors: Can multiple side effects be seen in a patient?

2021 ◽  
pp. 107815522110381
Author(s):  
Esra Özyurt ◽  
Serhat Özçelik ◽  
Heves Sürmeli ◽  
Mehmet Çelik ◽  
Murat Ayhan ◽  
...  
Keyword(s):  
T Cells ◽  
Cell Death ◽  
Side Effects ◽  
Programmed Cell Death ◽  
Adverse Events ◽  
Checkpoint Inhibitors ◽  
Host Cells ◽  
Immunoglobulin G4 ◽  
Programmed Cell Death 1 ◽  
Recurrent Renal Cell Carcinoma

Introduction Nivolumab is a human immunoglobulin G4 monoclonal antibody that inhibits programmed cell death-1 activity by binding to the programmed cell death-1 receptors. Cancer cells express increased number of programmed cell death-1 ligands and this allows them to escape the cytotoxic effects of the T cells. Therefore, the negative programmed cell death-1 receptor signal regulates T-cell proliferation and activation is disrupted. However, this change in the activity of the T cells can cause them to lose their ability to recognize host cells. The immune response enabled by these agents has led to side effects, commonly known as “immune-related adverse events.” Case report We report a case of a 66-year-old male patient who was treated with nivolumab for recurrent renal cell carcinoma presented with hepatitis and adrenalitis. Three weeks after starting nivolumab, the patient had abdominal pain and weakness, and then aspartate and alanine transaminase levels were found to be elevated. Management and outcome Hepatitis was predicted to be due to nivolumab, because other causes were excluded. He started using oral methylprednisolone and then, hepatitis improved. However, while receiving methylprednisolone treatment, fludrocortisone was started with the pre-diagnosis of adrenalitis due to the persistence of fatigue, weakness, and hyponatremia and hyperkalemia. With both treatments, the patient's symptoms and sodium and potassium level returned to normal. Discussion This case emphasizes the need for patient's education and awareness of immune-related adverse events, and the importance of understanding the management of life-threatening complications of the checkpoint inhibitors, because these side effects require prompt recognition and treatment.

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