Dr. Sweis on the Frequency of Immune-Related Adverse Events in Kidney Cancer

Randy F. Sweis, MD, instructor of medicine, University of Chicago Medicine, discusses the frequency of immune-related adverse events (irAEs).

The frequency of irAEs depends on the type of immunotherapy and whether it is used as a single agent or combination, says Sweis. A single-agent immunotherapy can manifest in irAEs in up to 50% of patients. The majority of these side effects, notes Sweis, will be lower in intensity, such as a mild rash and some fatigue. A rash, says Sweis, can be treated with a topical steroid without a physician having to hold the therapy.

Additionally, physicians use a grading system to grade toxicities on a scale of 1 to 4, 4 being the most severe. Whether physicians have to hold therapy or administer steroids, or other advanced drugs that block the immune system, depends on the grade of the toxicity, says Sweis. For many grade 1 toxicities, physicians can continue with treatment. Grade 2 toxicities and above require more careful management that often require physicians to hold therapy and administer drugs that block the immune response. That applies to both monotherapies and combinations, explains Sweis.