PD-1 and PD-L1 targeting drugs side effects/management

[Olga]

There is some interest in our community in PD-1 and PD-L1 targeting drugs from immune targeting class of drugs. Some of them are still in clinical trials but some are approved for melanoma and other advanced diseases and are being offered to our patients by their oncologists off label - i.e. not for indications they are approved for but because there are no other systemic treatment options the doctors can offer.
The side effects of these drugs are very different from the other ones and very specific. There is a new free full text article you can read to make yourself familiar with the side effects and their management:

Managing immune checkpoint-blocking antibody side effects.
http://www.ncbi.nlm.nih.gov/pubmed/25993145

The programmed cell death-1 (PD-1) receptor and one of its ligands, PD-L1, more recently have shown great promise as therapeutic targets in a variety of malignancies. Nivolumab and pembrolizumab recently have been FDA- approved for patients with melanoma and additional approvals within this therapeutic class are expected. The use of anti-CTLA-4 and anti-PD-1/PD-L1 antibodies is associated with side effects known as immune-related adverse events (irAEs). Immune-related adverse events affect the dermatologic, gastrointestinal, hepatic, endocrine, and other organ systems. Temporary immunosuppression with corticosteroids, tumor necrosis factor-alpha antagonists, mycophenolate mofetil, or other agents can be effective treatment. This article describes the side-effect profile of the checkpoint-blocking antibodies that target CTLA-4 and PD-1/PD-L1 and provides suggestions on how to manage specific irAEs.

[D.ap]

Olga
If you think this not applicable then I can delete and move to publications
I feel that with the drug resistance and rebound effects of alot of the PD drugs that some peolple should consult their incologist with the possible combined use?

Sequencing of BRAF inhibitors and ipilimumab in patients with metastatic melanoma: a possible algorithm for clinical use


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3464706/


BRAF mutations explained in molecular journal
http://mct.aacrjournals.org/content/10/3/385.full
Disclosure of Potential Conflicts of Interest

No potential conflicts of interest were disclosed.


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Grant Support

E.R Cantwell-Dorris is funded by the Health Research Board of Ireland's PhD Scholars Programme.

The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
Received August 25, 2010.
Revision received November 15, 2010.
Accepted December 8, 2010.
©2011 American Association for Cancer Research.

[Olga]

I opened a new forum here:
http://www.cureasps.org/forum/viewforum.php?f=70