Dr. Brahmer on Side Effects of Immunotherapy for Lung Cancer

Julie R. Brahmer, MD, associate professor of oncology, co-director of the Upper Aerodigestive Department, Bloomberg Kimmel Institute for Cancer Immunotherapy, Johns Hopkins Medicine, discusses managing adverse events (AEs) of immunotherapy in lung cancer.

No therapy is without AEs including immunotherapy, says Brahmer. However, checkpoint inhibitors have different AEs compared with chemotherapy, making it important for physicians to understand how to treat the toxicities and also help patients know what to look for. There are ASCO and NCCN guidelines on how best to follow, treat, and monitor patients for these toxicities. It is also important to help educate the team of physicians who treat patients.

The mainstay of therapy is to give steroids, which are immuno-suppressive, but the response rates do not diminish the checkpoint blockade from a tumor standpoint. However, the steroids do relieve the toxicities. Patients with endocrinopathies, such as hypothyroidism or hyperthyroidism, can be treated and do well long-term, says Brahmer.