High Dose Cyclophosphamide for the Treatment of Severe Immune Checkpoint Inhibitor Related Adverse Events

Details

• Personal Author:
  Braunschweig I ; Cooper D ; Davis T ; Fedorov K ; Feldman E ; Goldfinger M ; Gregos PS ; Gritsman K ; Konopleva M ; Kornblum N ; Mantzaris I ; Shah N ; Shapiro LC ; Shastri A ; Sica RA ; Verma A
• Description:
  Introduction: Immune-related adverse events (irAEs) are a group of autoimmune syndromes that arise following therapy with immune checkpoint inhibitors (ICIs) and are characterized by disinhibition of cell-mediated immunity and decreased self-tolerance. First line treatment of irAEs is typically steroids. Severe irAEs that are refractory to steroids can be life threatening and treatment protocols are an area of unmet need. Standardized clinical guidelines for management of severe corticosteroid refractory irAEs are currently not available and thus are an area of unmet need. Cases: We present two patients who were treated with nivolumab and subsequently developed steroid refractory irAEs in the forms of transverse myelitis, arthritis, and peri-engraftment respiratory distress syndrome. Conclusions: Treatment with a single high dose of cyclophosphamide resulted in rapid and sustained clinical improvements in two patients experiencing steroid refractory irAEs following ICI therapy. Cyclophosphamide may benefit patients with wide spectrum of irAEs while having a favorable toxicity profile. [Description provided by NIOSH]
• Subjects:
  Immune System Occupational Health Safety Steroids
• Keywords:
  Author Keywords: Immune Checkpoint Inhibitors Autoimmune Diseases Cancer Therapy Case Reports Cyclophosphamide Immune-related Adverse Events Immune Reaction Immunologic Disorders Immunology Immunology Of T-Cells Immunotherapy

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• ISSN:
  2574-710X
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New Jersey ; New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  8
• Issue:
  4
• NIOSHTIC Number:
  nn:20070829
• Citation:
  J Oncol Res Ther 2023 Dec; 8(4):10194
• Contact Point Address:
  Kateryna Fedorov, Montefiore Medical Center, Department of Oncology, 111 East 210th street, Bronx, York, USA
• CAS Registry Number:
  Cyclophosphamide (CAS RN 50-18-0)
• Federal Fiscal Year:
  2024
• Performing Organization:
  Albert Einstein College of Medicine, Bronx, New York
• Peer Reviewed:
  True
• Start Date:
  20210701
• Source Full Name:
  Journal of Oncology Research and Therapy
• End Date:
  20240630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:bfdae0d9e77abc0b6ae2d2318b4c4969e93ae791b1ad543f84b66012d9c86c86cdb772e671e2a4d2fb3ef85529bb1e4e2f823f19e2c79e693b14917a2ef31dee
• Download URL:
  https://stacks.cdc.gov/view/cdc/208977/cdc_208977_DS1.pdf
• File Type:
  [PDF - 753.07 KB ]