Side-effects of modern immunotherapy and how to solve them in the clinics

Abstract

Background: The Standard treatment of advanced melanoma has been changing in recent years. Palliative chemotherapy is being replaced by more efficient targeted therapies and modern immunotherapies based on antibodies against checkpoints of the immune response (so-called checkpoint inhibitors). Today's standard ipilimumab (anti-CTLA-4 antibody) could significantly prolong overall survival and achieved long-term disease control in about 20% of patients. There are other perspective immune modulating agents, such as anti-PD-1 antibodies (nivolumab, pembrolizumab, pidilizumab) and anti-PD-L1 antibodies. Unique mechanism of action is accompanied by new types of immune-related adverse events. Aim: The aim of the article is to summarize current knowledge about the toxicity of these antibodies and propose solutions in routine clinical practice.