Immune-Mediated Adverse Reactions
Antitumor immune activity can also affect healthy cells
Tumor cells are mutated versions of normal cells—they have changed into tumor cells that now grow uncontrollably.1 To survive and reproduce, however, tumor cells still use some of the same processes as normal cells.2
Immuno-Oncology therapies activate the immune response to overcome tumor survival and growth strategies.3 This can enable the immune system to attack healthy cells along with tumor cells. These effects are known as immune-mediated adverse reactions.3
Immune cells and immune-mediated adverse reactions
The link between immune activation and immune-mediated adverse reactions is an area of ongoing research. The activation of certain immune cells has been associated with autoimmunity.4 This connection may influence the likelihood of an immune-mediated adverse reaction.5
- T cells: T-cell activation has been linked to immune attack on normal cells and the development of autoimmunity.6 This may lead to immune-mediated adverse reactions in certain organ systems.3
- Natural Killer (NK) cells: The potential link between NK cells and the development of immune-mediated adverse reactions is less clear. Studies have shown that NK cells may protect against autoimmunity.6-9
Activating and inhibitory pathways modulate immune-cell activation and the stimulation of an immune response.10,11 These pathways can vary in the intensity of their effect on immune activity.12 The dynamic expression of a receptor and its ligand can dictate the potency of a particular pathway in the immune response.12 The activation or inhibition of certain pathways has been associated with autoimmunity.12,13
Exploring the relationship between immune activation and autoimmunity may provide a better understanding of immune-mediated adverse reactions.
Managing complications of immune-mediated adverse reactions
Patients, caregivers, and physicians should be educated to remain vigilant throughout and after Immuno-Oncology treatment to minimize complications, some of which may be life threatening.3 In addition, treatment algorithms are available for use by healthcare providers to assist them in managing immune-mediated adverse reactions.14-16 Recent guidelines have been published that provide consensus recommendations for the management of immune-mediated adverse reactions.15,16 Specific guidance for managing immune-mediated adverse reactions for an individual product can be found in the accompanying FDA-approved prescribing information.
As research in immune-system activation advances and more data are made available, understanding and appropriate management of immune-mediated adverse reactions will evolve.17
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