Immune Oncology - Immune-Related AEs (irAEs)

Question 1

How do we counsel pts with respect to immune-related AEs?

Answer 1

Continuously monitor themselves every day > do head-to-toe checks

Question 2

What is the mainstay tx of an immune-related AE

Answer 2

systemic steroids (prednisone or methylprednisolone)

Question 3

How do we tx Grade 1 immune-related AEs?

Answer 3

Supportive care +/- withhold drug

Question 4

How do we tx Grade 2 immune-related AEs?

Answer 4

Withhold drug, wait for tox to return to Grade 1 or lower

Question 5

What do we do if a Grade 2 irAE doesn’t go back to Grade 1 or lower within a week?

Answer 5

Low-dose CS’s

Question 6

How do we tx Grade 3/4 immune-related AEs?

Answer 6

d/c drug + high dose CS’s tapered over ≥ 1 month; d/c when tox resolves to grade ≤ 1

Question 7

T or F: CS tx for irAE reduces efficacy of the immune oncology tx due to immunosuppression.

Answer 7

F

Question 8

What is req’d when starting CS’s for irAEs?

Answer 8

Slow taper

Question 9

What is psuedoprogression?

Answer 9

When tumor appears as though it has progressed, but it really hasn’t > it only appears bigger due to increased inflammation

Question 10

T or F: Pseudoprogression is a common observation in both immune cancer tx and classic chemotx tx’s.

Answer 10

F

It’s ONLY observed in immune oncology tx

Question 11

Name two immunomodulatory imide drugs

Answer 11

Thalidomide, lenalidomide, pomalidomide

Question 12

MOA of immunomodulatory imide (IMiDs)

Answer 12

Antangiogenic effects and inhibition of proinflammatory cytokines