Immunotherapy toxicities
Immunotherapy toxicities
Dr Fiona Taylor
Outline
? Understand toxicities ? Anticipate toxicities ? Manage toxicities
Key steps to safely using and achieving the most benefits from immunotherapies for patients
Immunotherapies are novel agents
? Increasing use
? NICE/CDF approved ? Clinical Trials
? Therefore more likely to encounter patients with immunotherapy toxicities
? On the wards, in clinics, calling the hotline...
? Toxicities may become more complicated
? Combination with chemotherapy, radiotherapy and other immunotherapies
Patient assessment
How are you going to assess a patient commencing immunotherapy?
Clinical ? PS 0 or 1 or 2 ? Co-morbidities ? Medications
Baseline assessment
Autoimmune diseases 7.5mg prednisolone, potential drug interactions
Bloods
? FBC U+E LFTs
? Blood borne viruses
HIV, Hep B and C
? Quantiferon test
active or latent TB
? Baseline hormone/endocrine profile
FSH, LH, oestradiol/testosterone
prolactin
9am cortisol, ACTH
TSH, free T4
glucose, IGF-1
(Additional bloods for combination immunotherapy
Amylase, lipase)
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