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" Oncologic Emergencies: Immune-Based Cancer Therapies and Complications "
Long, Brit Jeffrey; Brém, Elizabeth; Koyfman, Alex
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AL
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| Record Number
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932660
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LA8hm46787
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| Language of Document
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English
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| Main Entry
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Long, Brit Jeffrey; Brém, Elizabeth; Koyfman, Alex
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| Title & Author
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Oncologic Emergencies: Immune-Based Cancer Therapies and Complications [Article]\ Long, Brit Jeffrey; Brém, Elizabeth; Koyfman, Alex
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| Title of Periodical
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Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
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21/3
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| Date
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2020
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| Abstract
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Cancer therapies have undergone several recent advancements. Current cancer treatments include immune-based therapies comprised of checkpoint inhibitors, and adoptive immunotherapy; each treatment has the potential for complications that differ from chemotherapy and radiation. This review evaluates immune-based therapies and their complications for emergency clinicians. Therapy complications include immune-related adverse events (irAE), cytokine release syndrome (CRS), autoimmune toxicity, and chimeric antigen receptor (CAR) T-cell-related encephalopathy syndrome (CRES). Immune-related adverse events are most commonly encountered with checkpoint inhibitors and include dermatologic complications, pneumonitis, colitis/diarrhea, hepatitis, and endocrinopathies. Less common irAEs include nephritis, myocardial injury, neurologic toxicity, ocular diseases, and musculoskeletal complications. CRS and CRES are more commonly associated with CAR T-cell therapy. CRS commonly presents with flu-like illness and symptoms resembling sepsis, but severe myocardial and pulmonary disease may occur. Critically ill patients require resuscitation, broad-spectrum antibiotics, and hematology/oncology consultation.
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