Management of adverse effects by molecular targeted therapy and immunotherapy

Abstract

Although molecular-targeted therapies have markedly developed as drugs targeting at cancer-specified molecular lesions, there are peculiar adverse effects to be managed including dermatitis, diarrhea, mucositis, and interstitial lung disease. It is important to assess risk-benefit balance maximizing the benefits of patients treated by anticancer drugs. Immune checkpoint inhibitors developed recently have shown clinically significant antitumor response for malignant melanoma and lung cancer. Immune therapies also have particular adverse effect including interstitial lung disease, liver injury, and skin eruption. It is noteworthy that these drugs may produce autoimmune disturbance associated with immune-related adverse events (ir-AEs) such as hypothyroidism, systemic lupus erythematosus, arthritis, and intestinal disorders. Most of managements of adverse effect by molecular-targeted therapy and immunotherapy have not been established based on evidential data; however, precise medicine for toxicities is required for individual patient with cancer. Managements of adverse effects of molecular-targeted therapy are thought to be beyond one oncologist capacity. Team medicine and proper consult to specialist are essential to appropriate treatment for patients with malignant tumor.