[The pathology of adverse events with immune checkpoint inhibitors].

Koelzer, V H; Glatz, K; Bubendorf, L; Weber, A; Gaspert, A; Cathomas, G; Lugli, Alessandro; Zippelius, A; Kempf, W; Mertz, K D (2017). [The pathology of adverse events with immune checkpoint inhibitors]. Der Pathologe, 38(3), pp. 197-208. Springer 10.1007/s00292-017-0281-1

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BACKGROUND

Immunotherapy has gained importance with the development of new effective cancer treatments. Immune checkpoint inhibitors (ICI) are monoclonal antibodies that promote T‑cell mediated tumor immune rejection. Checkpoint blockade also carries the risk of inducing autoimmune reactions ("immune related adverse events", irAEs). The diagnosis and classification of irAEs constitute a new and important field in pathology.

AIM

Practice-oriented review of the diagnosis and classification of irAEs.

MATERIALS AND METHODS

Structured, selective literature review based on PubMed und UpToDate ® online.

RESULTS

The most common irAEs affect the skin, the gastrointestinal tract, the liver, and the respiratory system. The correct diagnosis and classification of irAEs by an interdisciplinary care team is essential for appropriate therapy and the prevention of long-term sequelae. Other important irAEs affect the endocrine organs, the heart, the joints, the kidneys and the nervous system. Because of their rarity and/or limited options for bioptic diagnosis, only limited data on the morphology and pathophysiology of these irAEs are currently available. Autopsies carried out after ICI therapy constitute an important element of quality control and allow better documentation of the incidence and pathogenesis of irAEs.

DISCUSSION

Pathology plays a central role in the diagnosis and treatment of irAEs. Future studies may contribute to a better mechanistic understanding of irAEs for individualized knowledge-based risk assessment.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute of Pathology
04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology

UniBE Contributor:

Lugli, Alessandro

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

1432-1963

Publisher:

Springer

Language:

German

Submitter:

Alessandro Lugli

Date Deposited:

13 Feb 2018 17:08

Last Modified:

05 Dec 2022 15:10

Publisher DOI:

10.1007/s00292-017-0281-1

PubMed ID:

28421272

Uncontrolled Keywords:

Adverse drug event Autoimmunity Immunotherapy Personalized medicine

BORIS DOI:

10.7892/boris.110700

URI:

https://boris.unibe.ch/id/eprint/110700

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