Immune-Related Adverse Events (irAEs): Diagnosis, Management, and Clinical Pearls

Abstract

Purpose of review: While immune checkpoint inhibitor (ICI) therapy has improved melanoma patient outcomes, it has also resulted in the rise of unique immune-related adverse events (irAEs). Here, we review and synthesize irAE management recommendations from several oncological societies into a streamlined format to aid in diagnosis and management. We also include clinical pearls highlighting several recent research studies in this field.

Recent findings: Knowledge of immunotherapy toxicity has continually evolved, and several major oncologic societies have recently released new or updated guidelines. Keeping up with the evolving field of immunotherapy and related toxicities is crucial, because ICI use, in combination with other agents, will only continue to increase and likely result in new and different patterns of irAEs. Providing clear and concise references for clinicians will help ensure proper irAE evaluation and management going forward. We present one such reference here, covering management of common and/or serious irAEs.

Keywords: Anti-CTLA-4; Anti-PD-1; Colitis; Diabetes; Hepatitis; Hypophysitis; Hypothyroidism; ICI-induced toxicity; Immune-related adverse event; Immunosuppression; Immunotherapy; Ipilimumab; Melanoma; Myocarditis; Nivolumab; Pembrolizumab; Pneumonitis; Steroids; Toxicity; irAE.