Douglas Johnson, MD, MSCI, associate professor of Medicine at Vanderbilt University Medical Center and clinical director of Melanoma at Vanderbilt-Ingram Cancer Center speaks about Forty-three Percent Of Melanoma Patients Have Chronic Complications From Immunotherapies.
Link to Article:
https://news.vumc.org/2021/03/25/forty-three-percent-of-melanoma-patients-have-chronic-complications-from-immunotherapies/
According to a report published March 25 in JAMA Oncology, chronic side effects among melanoma survivors treated with anti-PD-1 immunotherapies are more frequent than previously thought.
Chronic complications, which affected 43% of patients, mainly affected the joints and endocrine system, with salivary glands, lungs, peripheral nerves, and other organs coming in second and third. Just 14% of cases were resolved at the last follow-up, indicating that these problems could last a long time. This result contrasted with prior records of immunotherapy-related acute complications affecting visceral organs such as the liver, colon, lungs, and kidneys, all of which were successfully treated with steroids. The vast majority of chronic complications, on the other hand, were not serious or life-threatening.
"Chronic and long-lasting side effects were more common than we expected and involved a variety of often overlooked organs like the thyroid, salivary glands, and joints," said the study"™s senior author, Douglas Johnson, MD, MSCI, associate professor of Medicine at Vanderbilt University Medical Center and clinical director of Melanoma at Vanderbilt-Ingram Cancer Center.
Between 2015 and 2020, researchers looked at the frequency and range of chronic immune-related adverse effects in melanoma patients treated with adjuvant anti-PD-1 immunotherapies (pembrolizumab or nivolumab) at eight academic medical centers. Chronic side effects were described as those that lasted for at least 12 weeks after the immunotherapy treatment had finished. The research is the first to look at anti-PD-1-related chronic complications in patients with resected high-risk melanoma.
The majority (96 percent) of chronic complications were grade 1 or 2 cases with no or minor symptoms. Adrenal insufficiency, arthritis, dermatitis, and thyroiditis were among the most common side effects.
Rare and acute immune-related adverse effects, such as cardiovascular complications, that arise early in the course of immunotherapy care may be more severe. Johnson and his Vanderbilt-Ingram colleagues were the first to record unusual but fatal cardiac side effects from immunotherapies in 2016.
"While these side effects are important to monitor and treat, anti-PD-1 therapies remain life-saving for many patients with melanoma," Johnson said.
The study"™s lead author is J. Randall Patrinely, Jr., BA. Other contributing authors from Vanderbilt included Fei Ye, Ph.D.; Ran Fan, Ph.D., and Elizabeth Davis, MD.