Beth Eaby-Sandy, a nurse practitioner, discussed AEs associated with immunotherapy treatment in patients with lung cancer.
Immunotherapy is a form of cancer treatment that is now being used to treat many different types of cancer. However, stimulating the immune system through activated t-cells may result in T-cells acting upon other body systems or organs, unable to distinguish the cancer, causing inflammation and other adverse events (AEs).
Beth Eaby-Sandy, nurse practitioner at the Abramson Cancer Center, spoke at the CURE patient-focused sessions held in tandem with the Annual New York Lung Cancers Symposium® about immunotherapy AE management. “Your body is in a constant state of self-tolerance,” she said. “These drugs that we use do 1 of 2 things. We are either trying to stimulate the immune system to kill cancer… [or] we’re trying to stop cancer from alluding the immune system.”1
Any body system or organ can become inflamed or damaged by the overactivity of T-cells. Some types of immunotherapy may result in severe inflammation-related reactions. If patients are experiencing any AEs from immunotherapy, they should be seen and treated immediately.
Hypothyroidism is one of the most common AEs caused by immunotherapy. Once immunotherapy disables the thyroid gland, it is permanent, and the patient will not regain thyroid function and must then be on levothyroxine for life. Patients may also experience hyperthyroidism, though less common, causing a patient to over-secrete thyroxine and can lead to hypothyroidism if prolonged.
Fatigue is commonly reported in patients who receive immunotherapy, though it is unclear as to what causes it. Another common AE of immunotherapy can be arthritis, induced by T-cells attacking the joints. Low-dose steroids or other drugs traditionally used to manage arthritis are recommended for patients. Nausea and diarrhea (without colitis) have been reported, though not necessarily known why.
More AEs include:
Lowering of blood counts is not commonly seen in immunotherapy as it is in chemotherapy. Hair loss should also not occur, though hair thinning may.
“Don’t be afraid of immunotherapy! The majority of these patients do very, very well for often long periods of time, so it’s not something to be afraid of. We can usually manage these side effects very easily,” Eaby-Sandy said.
1. Eaby-Sandy. Immunotherapy Adverse Effect Management. Presented at: CURE patient-focused sessions held in tandem with the Annual New York Lung Cancers Symposium®; November 9, 2019; New York, New York.