For Providers
Toxicity Overview
Toxicities occur in most patients treated with immune checkpoint inhibitors, although more clinically severe toxicities arise in approximately 20% (anti-PD-1 or PD-L1 monotherapy) to 50% (combination PD-1/CTLA-4 blockade). Toxicities are autoimmune-like inflammation that may affect any organ system. The management of toxicities is largely based on severity and grade (see guidelines/CTCAE).
Mild and minimally symptomatic toxicities may be managed with supportive care and close monitoring (e.g., topical steroids for a mild rash).
Severe and life-threatening toxicities usually require the following:
- High-dose glucocorticoid therapy (prednisone 1-2mg/kg or equivalent)
- Withholding immune checkpoint inhibitor therapy
- Supportive management (e.g., supplemental oxygen for hypoxia in pneumonitis)