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      Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immune checkpoint inhibitor-related adverse events

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          Abstract

          Immune checkpoint inhibitors (ICIs) are the standard of care for the treatment of several cancers. While these immunotherapies have improved patient outcomes in many clinical settings, they bring accompanying risks of toxicity, specifically immune-related adverse events (irAEs). There is a need for clear, effective guidelines for the management of irAEs during ICI treatment, motivating the Society for Immunotherapy of Cancer (SITC) to convene an expert panel to develop a clinical practice guideline. The panel discussed the recognition and management of single and combination ICI irAEs and ultimately developed evidence- and consensus-based recommendations to assist medical professionals in clinical decision-making and to improve outcomes for patients.

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          Pembrolizumab plus Chemotherapy in Metastatic Non–Small-Cell Lung Cancer

          First-line therapy for advanced non-small-cell lung cancer (NSCLC) that lacks targetable mutations is platinum-based chemotherapy. Among patients with a tumor proportion score for programmed death ligand 1 (PD-L1) of 50% or greater, pembrolizumab has replaced cytotoxic chemotherapy as the first-line treatment of choice. The addition of pembrolizumab to chemotherapy resulted in significantly higher rates of response and longer progression-free survival than chemotherapy alone in a phase 2 trial.
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            Atezolizumab and Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer

            Unresectable locally advanced or metastatic triple-negative (hormone-receptor-negative and human epidermal growth factor receptor 2 [HER2]-negative) breast cancer is an aggressive disease with poor outcomes. Nanoparticle albumin-bound (nab)-paclitaxel may enhance the anticancer activity of atezolizumab.
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              Pembrolizumab plus Chemotherapy for Squamous Non–Small-Cell Lung Cancer

              Standard first-line therapy for metastatic, squamous non-small-cell lung cancer (NSCLC) is platinum-based chemotherapy or pembrolizumab (for patients with programmed death ligand 1 [PD-L1] expression on ≥50% of tumor cells). More recently, pembrolizumab plus chemotherapy was shown to significantly prolong overall survival among patients with nonsquamous NSCLC.
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                Author and article information

                Journal
                J Immunother Cancer
                J Immunother Cancer
                jitc
                jitc
                Journal for Immunotherapy of Cancer
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2051-1426
                2021
                25 June 2021
                : 9
                : 6
                : e002435
                Affiliations
                [1 ]departmentDepartment of Oncology and the Thoracic Oncology , Johns Hopkins Sidney Kimmel Cancer Center , Baltimore, Maryland, USA
                [2 ]departmentDepartment of Internal Medicine , University of Missouri-Kansas City , Kansas City, Missouri, USA
                [3 ]departmentUnit of Melanoma Cancer Immunotherapy and Innovative Therapy , National Tumour Institute IRCCS Fondazione 'G. Pascale' , Napoli, Italy
                [4 ]departmentDepartment of Medicine , University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania, USA
                [5 ]departmentDepartment of Medicine , Johns Hopkins University School of Medicine , Baltimore, Maryland, USA
                [6 ]Massachusetts General Hospital , Boston, Massachusetts, USA
                [7 ]New York Nephrology Vasculitis and Glomerular Center , Albany, New York, USA
                [8 ]departmentDepartment of Hematology and Oncology , Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center , Dallas, Texas, USA
                [9 ]departmentDepartment of Pharmacy , Roswell Park Comprehensive Cancer Center , Buffalo, New York, USA
                [10 ]departmentDepartment of Medicine , Roswell Park Comprehensive Cancer Center , Buffalo, New York, USA
                [11 ]departmentDepartment of Medicine , Vanderbilt-Ingram Cancer Center , Nashville, Tennessee, USA
                [12 ]departmentDepartment of Medicine , Memorial Sloan Kettering Cancer Center , New York, New York, USA
                [13 ]departmentDepartment of Medicine , Helen F. Graham Cancer Center , Newark, Delaware, USA
                [14 ]departmentDepartment of Oncology , Beaumont Hospital Dublin, The Royal College of Surgeons of Ireland , Dublin, Ireland
                [15 ]departmentDepartment of Neurology , Memorial Sloan Kettering Cancer Center , New York, New York, USA
                [16 ]Cancer Specialist of North Florida , Fleming Island, Florida, USA
                [17 ]departmentDepartment of Ophthalmology and Visual Science , University of Chicago Medical Center , Chicago, Illinois, USA
                [18 ]departmentRobert H. Lurie Comprehensive Cancer Center , Northwestern University Medical Center , Chicago, Illinois, USA
                [19 ]departmentDivision of Cancer Treatment & Diagnosis , National Cancer Institute , Rockville, Maryland, USA
                Author notes
                [Correspondence to ] Dr Marc S Ernstoff; marc.ernstoff@ 123456nih.gov
                Author information
                http://orcid.org/0000-0002-8322-475X
                http://orcid.org/0000-0002-8132-7069
                Article
                jitc-2021-002435
                10.1136/jitc-2021-002435
                8237720
                34172516
                24db1837-396c-4c81-9792-3b3ba5064243
                © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 24 March 2021
                Categories
                Position Article and Guidelines
                1506
                2446
                Custom metadata
                unlocked

                antineoplastic protocols,guidelines as topic,immunotherapy

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