Imaging of Adverse Events Related to Checkpoint Inhibitor Therapy
Abstract
:1. Introduction
2. Mechanisms Underlying irAEs
3. Grading Severity of irAEs
4. Chronology of irAEs
5. Treatment of Adverse Events
5.1. Treatment of Gastrointestinal Toxicity
5.2. Treatment of Hepatic Toxicity
5.3. Treatment of Pulmonary Toxicity
5.4. Treatment of Thyroid Toxicity
6. Most Relevant Imaging Findings in irAEs
6.1. Colon
6.2. Liver
6.3. Lung
6.4. Endocrine System
6.4.1. Pituitary Gland
6.4.2. Thyroid
6.5. Pancreas
7. PET-CT: Confounder or Problem-Solving?
8. Less Frequent irAEs
8.1. Renal Toxicity
8.2. Cardiac Toxicity
8.3. Neurological Toxicity
9. Future Directions and Conclusions
Funding
Conflicts of Interest
Abbreviations
AIP/ARDS | Acute Interstitial Pneumonia/Acute Respiratory Distress Syndrome |
ALT | Alanine Transaminase |
ASCO | American Society of Clinical Oncology |
AST | Aspartate aminotransferase |
COP | Cryptogenic Organizing Pneumonia |
CT | Computed Tomography |
CTCAE | Common Terminology Criteria for Adverse Events |
CTLA-4 | Cytotoxic T-Lymphocyte–Associated Antigen 4 |
EMA | European Medicines Agency |
ESMO | European Society for Medical Oncology |
FDG-PET | Fluorodeoxyglucose-Positron Emission Tomography |
FT4 | Free Thyroxine |
HP | Hypersensitivity Pneumonitis |
HRT | Hormone Replacement Therapy |
ICIs | Immunotherapy with Checkpoint Inhibitors |
irAEs | immune-related Adverse Events |
MRI | Magnetic Resonance Imaging |
NCCN | National Comprehensive Cancer Network |
NCI-CTCAE | National Cancer Institute - Common Terminology Criteria for Adverse Events |
NSIP | Non-Specific Interstitial Pneumonia |
PD-1 | Programmed Death 1 |
PD-L1 | Programmed Death-Ligand 1 |
RR | Relative Risk |
SCAD | Segmental Colitis Associated with Diverticulosis |
TSH | Thyroid-Stimulating Hormone |
U.S. FDA | United States Food and Drug Administration |
US | Ultrasound |
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ICIMechanism of Action | Indication | |
---|---|---|
Ipilimumab Anti-CTLA-4 antibody | • Unresectable or Metastatic Melanoma • Adjuvant Treatment of Melanoma • Advanced Renal Cell Carcinoma • Microsatellite Instability-High (MSI-H) or Mismatch Repair Deficient (dMMR) Metastatic Colorectal Cancer | |
Pembrolizumab Anti-PD-1 antibody |
• Melanoma • Non-Small Cell Lung Cancer • Small Cell Lung Cancer • Head and Neck Squamous Cell Cancer • Classical Hodgkin Lymphoma • Primary Mediastinal Large B-Cell Lymphoma • Urothelial Carcinoma • Microsatellite Instability-High Cancer |
• Gastric Cancer • Esophageal Cancer • Cervical Cancer • Hepatocellular Carcinoma • Merkel Cell Carcinoma • Renal Cell Carcinoma • Endometrial Carcinoma |
Nivolumab Anti-PD-1 antibody |
• Unresectable or Metastatic Melanoma • Adjuvant Treatment of Melanoma • Metastatic Non-Small Cell Lung Cancer • Small Cell Lung Cancer • Advanced Renal Cell Carcinoma • Classical Hodgkin Lymphoma |
• Squamous Cell Carcinoma of the Head and Neck • Urothelial Carcinoma • Microsatellite Instability-High or Mismatch Repair Deficient Metastatic Colorectal Cancer • Hepatocellular Carcinoma. |
Ipilimumab + nivolumab | • Unresectable or metastatic melanoma | |
Atezolizumab Anti-PD-L1 antibody |
• Urothelial Carcinoma • Non-Small Cell Lung Cancer • Locally Advanced or Metastatic Triple-Negative Breast Cancer • Small Cell Lung Cancer | |
Avelumab Anti-PD-L1 antibody |
• Metastatic Merkel Cell Carcinoma • Locally Advanced or Metastatic Urothelial Carcinoma • Advanced Renal Cell Carcinoma | |
Durvalumab Anti-PD-L1 antibody |
• Urothelial Carcinoma • Non-Small Cell Lung Cancer | |
Cemiplimab Anti-PD-1 antibody | • Metastatic Cutaneous Squamous Cell Carcinoma (CSCC) • Locally Advanced CSCC |
Diffuse Colitis | Segmental Colitis |
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Vani, V.; Regge, D.; Cappello, G.; Gabelloni, M.; Neri, E. Imaging of Adverse Events Related to Checkpoint Inhibitor Therapy. Diagnostics 2020, 10, 216. https://doi.org/10.3390/diagnostics10040216
Vani V, Regge D, Cappello G, Gabelloni M, Neri E. Imaging of Adverse Events Related to Checkpoint Inhibitor Therapy. Diagnostics. 2020; 10(4):216. https://doi.org/10.3390/diagnostics10040216
Chicago/Turabian StyleVani, Vanina, Daniele Regge, Giovanni Cappello, Michela Gabelloni, and Emanuele Neri. 2020. "Imaging of Adverse Events Related to Checkpoint Inhibitor Therapy" Diagnostics 10, no. 4: 216. https://doi.org/10.3390/diagnostics10040216