Multidisciplinary recommendations for essential baseline functional and laboratory tests to facilitate early diagnosis and management of immune-related adverse events among cancer patients

Berna C Özdemir¹, Cristina Espinosa da Silva^{2

3}, Dimitri Arangalage⁴, Pierre Monney⁵, Sabina A Guler⁶, Uyen Huynh-Do⁷, Guido Stirnimann⁸, Lucia Possamai⁹, Roman Trepp¹⁰, Robert Hoepner¹¹, Anke Salmen¹¹, Camille L Gerard^{12

13}, Petr Hruz¹⁴, Lisa Christ¹⁵, Sacha I Rothschild^{16

17}

Affiliations

¹ Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Berna.oezdemir@insel.ch.
² Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA.
³ Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, USA.
⁴ Department of Cardiology, INSERM U1148, Bichat Hospital, University of Paris, Paris, France.
⁵ Department of Cardiology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
⁶ Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁷ Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁸ Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁹ Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.
¹⁰ Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism (UDEM), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
¹¹ Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
¹² Department of Oncology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
¹³ The Francis Crick Institute, London, UK.
¹⁴ Department of Gastroenterology, University Hospital Basel, Basel, Switzerland.
¹⁵ Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
¹⁶ Department of Medical Oncology, University Hospital Basel, Basel, Switzerland.
¹⁷ Department Internal Medicine, Center for Oncology and Hematology, Cantonal Hospital Baden, Baden, Switzerland.

PMID: 37017694
PMCID: PMC10264466
DOI: 10.1007/s00262-023-03436-0

Review

Multidisciplinary recommendations for essential baseline functional and laboratory tests to facilitate early diagnosis and management of immune-related adverse events among cancer patients

Berna C Özdemir et al. Cancer Immunol Immunother. 2023 Jul.

. 2023 Jul;72(7):1991-2001.

doi: 10.1007/s00262-023-03436-0. Epub 2023 Apr 5.

Authors

Affiliations

¹ Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Berna.oezdemir@insel.ch.
² Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA.
³ Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, USA.
⁴ Department of Cardiology, INSERM U1148, Bichat Hospital, University of Paris, Paris, France.
⁵ Department of Cardiology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
⁶ Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁷ Department of Nephrology and Hypertension, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁸ Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
⁹ Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.
¹⁰ Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism (UDEM), Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
¹¹ Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
¹² Department of Oncology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
¹³ The Francis Crick Institute, London, UK.
¹⁴ Department of Gastroenterology, University Hospital Basel, Basel, Switzerland.
¹⁵ Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
¹⁶ Department of Medical Oncology, University Hospital Basel, Basel, Switzerland.
¹⁷ Department Internal Medicine, Center for Oncology and Hematology, Cantonal Hospital Baden, Baden, Switzerland.

PMID: 37017694
PMCID: PMC10264466
DOI: 10.1007/s00262-023-03436-0

Erratum in

Correction to: Multidisciplinary recommendations for essential baseline functional and laboratory tests to facilitate early diagnosis and management of immune‑related adverse events among cancer patients.
Özdemir BC, Espinosa da Silva C, Arangalage D, Monney P, Guler SA, Huynh-Do U, Stirnimann G, Possamai L, Trepp R, Hoepner R, Salmen A, Gerard CL, Hruz P, Christ L, Rothschild SI. Özdemir BC, et al. Cancer Immunol Immunother. 2023 Jul;72(7):2003-2004. doi: 10.1007/s00262-023-03456-w. Cancer Immunol Immunother. 2023. PMID: 37154850 Free PMC article. No abstract available.

Abstract

Immune checkpoint inhibitors (ICIs) have fundamentally changed the treatment landscape of various cancers. While ICI treatments result in improved survival, quality of life and are cost-effective, the majority of patients experience at least one immune-related adverse event (irAE). Many of these side effects cause little discomfort or are asymptomatic; however, irAEs can affect any organ and are potentially life-threatening. Consequently, early diagnosis and appropriate treatment of irAEs are critical for optimizing long-term outcomes and quality of life in affected patients. Some irAEs are diagnosed according to typical symptoms, others by abnormal findings from diagnostic tests. While there are various guidelines addressing the management of irAEs, recommendations for the early recognition of irAEs as well as the optimal extent and frequency of laboratory tests are mostly lacking. In clinical practice, blood sampling is usually performed before each ICI administration (i.e., every 2-3 weeks), often for several months, representing a burden for patients as well as health care systems. In this report, we propose essential laboratory and functional tests to improve the early detection and management of irAEs and in cancer patients treated with ICIs. These multidisciplinary expert recommendations regarding essential laboratory and functional tests can be used to identify possible irAEs at an early time point, initiate appropriate interventions to improve patient outcomes, and reduce the burden of blood sampling during ICI treatment.

Keywords: Baseline evaluation; Diagnosis; Immune checkpoint inhibitors; Immune-related adverse events; Laboratory tests; Minimal data set.

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Conflict of interest statement

BCÖ received institutional honoraria for lectures and advisory boards from Bristol-Myers Squibb, MSD, Merck, Ipsen, Roche, Pfizer, Novartis, Janssen. GST received research funding from Bayer, consulting fee from Advanz Pharma and travel/accommodation support from Alnylam and Gilead. RH received speaker/advisor honoraria from Merck, Novartis, Roche, Biogen, Alexion, Sanofi, Janssen, Bristol-Myers Squibb, Teva/Mepha and Almirall and research grants from Roche, Merck, Sanofi, Biogen, Chiesi, and Bristol-Myers Squibb. AS received speaker honoraria and/or travel compensation for activities with Bristol-Myers Squibb, CSL Behring, Novartis, and Roche, and research support by the Baasch-Medicus Foundation, the Medical Faculty of the University of Bern and the Swiss MS Society, not related to this work.LC received research/non-financial support, advisory fee and stock ownership from Gilead Sciences, F. Hoffmann-La Roche, Novartis, Pfizer, Bristol-Myers Squibb, Sanofi. SIR received consulting or advisory fees from Bristol-Myers Squibb, AstraZeneca, Boehringer Ingelheim, Eisai, Roche, Novartis, Merck Serono, MSD Oncology, Pfizer, Takeda, AbbVie, research funding from Boehringer Ingelheim, AstraZeneca, Bristol-Myers Squibb, Eisai, Merck Serono, AbbVie, fees for expert testimony from Roche, AstraZeneca, Bristol-Myers Squibb, and travel/accommodation expenses from Roche Pharma AG, Lilly, Bristol-Myers Squibb, AstraZeneca, Merck Sharp & Dohme, Amgen. All other authors have no relevant financial or non-financial interest to disclose.

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Multidisciplinary recommendations for essential baseline functional and laboratory tests to facilitate early diagnosis and management of immune-related adverse events among cancer patients

Affiliations

Multidisciplinary recommendations for essential baseline functional and laboratory tests to facilitate early diagnosis and management of immune-related adverse events among cancer patients

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

References

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