Multinational Association of Supportive Care in Cancer (MASCC) 2020 clinical practice recommendations for the management of immune-mediated cardiovascular, rheumatic, and renal toxicities from checkpoint inhibitors

Maria E. Suarez-Almazor, Xerxes Pundole, Noha Abdel-Wahab, Douglas B. Johnson, Dipti Gupta, Ilya Glezerman, Tim Cooksley, Ronald Anderson, Ada Blidner, Jennifer Choi, Michael Dougan, Pamela Ginex, Monica Girotra, Vickie R. Shannon, Bernardo L. Rapoport*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Immune checkpoint inhibitors (ICIs) have emerged as the newest pillar of cancer treatment. Immune-mediated toxicities, stemming from increased activity within the T cell lineage, range from asymptomatic or mild complications to those that are fulminant and potentially fatal. Although they are of variable occurrence, cardiovascular, rheumatic, and renal immune-mediated toxicities are among the most serious of these adverse events. We present MASCC recommendations with respect to the workup and management of cardiovascular, rheumatic, and renal immune-mediated toxicities with a focus on presentations that require treatment with immunomodulating agents.

Original languageEnglish (US)
Pages (from-to)6159-6173
Number of pages15
JournalSupportive Care in Cancer
Volume28
Issue number12
DOIs
StatePublished - Dec 2020

Funding

Professor BL Rapoport is supported by supported by the Cancer Association of South Africa (CANSA) and the National Research Foundation (NRF) of South Africa. Dr. I. Glezerman is supported by the NIH/NCI (Cancer Center Support Grant P30 CA008748). Professor BL Rapoport is supported by supported by the Cancer Association of South Africa (CANSA) and the National Research Foundation (NRF) of South Africa. Dr. I. Glezerman is supported by the NIH/NCI (Cancer Center Support Grant P30 CA008748). AW, XP, AB, RA, JC, TC, PG, DG RAG, and VRS have no conflict of interest to declare. MD reports grants from Novartis, other (SAB) from Neoleukin Therapeutics, personal fees from Partner Therapeutics, personal fees from Tillotts Pharma, and grants from Genentech, outside the submitted work. MG reports consultant work with Bristol Myers Squibb (BMS), and AstraZeneca, outside the submitted work. IG reports other (Stock Ownership) from Pfizer Inc., and personal fees from CytomX Inc., outside the submitted work. DBJ reports other (advisory board) from Array Biopharma, grants and other (advisory board) from BMS, other (advisory board) from Jansen, grants from Incyte, other (advisory board) from Merck, and other (advisory board) from Novartis, outside the submitted work. In addition, DBJ has a patent co-inventor on use of CTLA-4 agonist for IAEs pending. BLR reports personal fees and other (advisory board) from Merck and Co.; grants, personal fees, and other (advisory board) from BMS; grants, personal fees, and other (advisory board) from Roche South Africa; and personal fees and other (advisory board) from AstraZeneca, during the conduct of the study. MSA reports personal fees from Gilead, grants from Pfizer, and personal fees from Abbvie, outside the submitted work.

Keywords

  • Arthralgia
  • Arthritis
  • Cardiomyopathy
  • Corticosteroids
  • Immunomodulation agents
  • Myocarditis
  • Myositis
  • Other immunosuppressive agents
  • Polymyalgia

ASJC Scopus subject areas

  • Oncology

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