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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