Toxicity of Immunotherapeutic Agents

Cristina Gutierrez; Colleen McEvoy; Daniel Reynolds; Joseph L Nates

doi:10.1016/j.ccc.2021.03.004

Toxicity of Immunotherapeutic Agents

Crit Care Clin. 2021 Jul;37(3):605-624. doi: 10.1016/j.ccc.2021.03.004.

Authors

Cristina Gutierrez¹, Colleen McEvoy², Daniel Reynolds³, Joseph L Nates⁴

Affiliations

¹ Department of Critical Care, Division of Anesthesiology and Critical Care, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard. Houston, TX 77030, USA. Electronic address: cgutierrez4@mdanderson.org.
² Stem Cell Transplant and Oncology Intensive Care Unit, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, 4523 Clayton Ave, St Louis, MO 63110, USA.
³ Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, 4523 Clayton Ave, St Louis, MO 63110, USA.
⁴ Department of Critical Care, Division of Anesthesiology and Critical Care, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard. Houston, TX 77030, USA.

PMID: 34053709
DOI: 10.1016/j.ccc.2021.03.004

Abstract

As the cancer population increases and immunotherapy becomes widely utilized, severe toxicities from these treatments will become more prevalent. In cancer patients, the most common immunotherapies that lead to critical illness are chimeric antigen receptor T cells, monoclonal antibodies, and immune checkpoint inhibitors. Awareness of their toxicities by the intensive care unit team is of extreme importance. A multidisciplinary approach for diagnosis and treatment is recommended. This article reviews the most common toxicities from immunotherapy and offers a therapy-specific and system-based approach for affected patients.

Keywords: Chimeric antigen receptor T-cells; Immune checkpoint inhibitors; Immunotherapy; Intensive care unit; Monoclonal antibodies; Toxicities.

Publication types

Review

MeSH terms

Antibodies, Monoclonal / adverse effects
Humans
Immunotherapy* / adverse effects
Neoplasms* / drug therapy

Substances

Antibodies, Monoclonal