Each week we will aim to bring out a concise email that provides 4-5 key pieces of information addressing a specific issue in clinical therapeutics.
This week: New Immunotherapy Agents for Cancer (Part 2)
Dr Natalie Soulsby, Director of Clinical Operations
Until recently the life expectancy of someone with metastatic melanoma (stage 4) was six to nine months, but since the introduction of new immunotherapy agents the life expectancy has increased to a point where up to > 50% of those affected will remain alive after two years, and about 12% of people will have gone into complete remission.
- However, these agents are not without their toxicities – furthermore the traditional toxicities seen with cytotoxic agents do not tend to be seen with the new immunotherapy drugs.
- Since toxicity is mainly expressed in the immune system, people who already have an autoimmune disease such as rheumatoid arthritis may be more prone to a flare up of their condition after commencing treatment and may require steroid treatment for this.
- Some of these autoimmune toxicities can manifest many months into treatment and so the patients need to be continually monitored for adverse effects.
- Adverse effects may affect any organ system and include hepatitis, enteritis, colitis, uveitis, pneumonitis, nephritis, hypo or hyperthyroidism, arthralgia and myositis.
- It is important to monitor for diarrhoea and abdominal cramping and if this occurs the patient needs to seek immediate medical treatment which would usually involve high dose steroids.
Please consider these issues when preparing or interpreting RMMR reports or education sessions. Contributions of content or suggested topics are welcome and should be sent directly to firstname.lastname@example.org.