SITC Immune Checkpoint Inhibitor-related Adverse Events Immunotherapy Guideline

SITC's Cancer Immunotherapy Guidelines program is a
collection of Clinical Practice Guidelines (CPGs) developed by multi-disciplinary panels of experts who draw from their own practical experience as  well as evidence in the published literature and clinical trial data to develop evidence- and consensus-based recommendations. SITC uses as a model the Institute of Medicine's 2011 "Standards for Developing Trustworthy Clinical Practice Guidelines" to ensure the recommendations are unbiased, transparent and balanced will aid oncologists in effective clinical decision-making concerning patient selection, toxicity management, response evaluation, and the sequencing or combination of therapies, among other topics.

The Immune Checkpoint Inhibitor-related Adverse Events Guideline Expert Panel was formed to generate consensus recommendations pertaining to the treatment of patients with Immune checkpoint inhibitors (ICIs). ICIs are antibodies designed to block key regulatory signals that dampen immune responses, counteracting immune suppression in the tumor microenvironment and thus enabling tumor-reactive T cells to mount a more effective anti-cancer response. While ICIs have improved patient outcomes in a number of clinical settings, the same mechanisms that underpin their effective anti-tumor properties may cause unique toxicities, specifically immune-related adverse events (irAEs). As ICIs increasingly become integrated into treatment plans for an ever-increasing number of disease settings, there is a need for clear, expert guidance on the recognition and management of irAEs. SITC assembled the expert panel to discuss and is currently generating recommendations on best practices for addressing some of the most commonly reported irAEs that arise during treatment with ICIs, including gastrointestinal, musculoskeletal, and dermatologic toxicities, among other key considerations for oncologists treating their patients with these agents. A companion guideline on the management of immune effector cell-related adverse events published on December 16, 2020 in the Journal for ImmunoTherapy of Cancer (JITC)

Published Guideline

Published June 25, 2021 in the Journal for ImmunoTherapy of Cancer (JITC) as "Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immune checkpoint inhibitor-related adverse events"

SITC is a proponent for collaboration and harmonization of efforts between like-minded organizations whenever possible. SITC wishes to thank the American Society for Transplantation and Cellular Therapy (ASTCT) for providing a representative to serve on SITC’s Immune Checkpoint Inhibitor-related Adverse Events Expert Panel to aid in the development of this clinical practice guideline.

READ GUIDELINE

Webinar Series

SITC is pleased to offer companion educational resources in support of the published Immune Checkpoint Inhibitor-related Adverse Events CPG. These activities feature faculty comprised of the guideline expert panel and are designed to provide a deeper understanding of the recommendations in the SITC guidelines and how to apply them in various clinical scenarios. The educational available features both webinars which are a longer-format recording that takes a deeper look at the guideline recommendations as well as mini-modules which are brief videos on a specific topic within the guideline content. Below is a list of the available educational resources for this CPG available free and on-demand.

Webinars:

• *Immune Checkpoint Inhibitor-related Adverse Events- SITC CPG Webinar
  • Leading experts in cancer immunotherapy presented an overview of the publication "Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immune checkpoint inhibitor-related adverse events" during a live webinar.

• Practical Management Pearls for Immune Checkpoint Inhibitor-related Adverse Events
  • This advanced webinar explains how to appraise and classify organ-specific considerations for immunotherapy agents and toxicities, identify and manage clinically significant uncommon toxicities, and determine optimal sequencing of immunotherapies in relapsed and/or refractory disease.

• Case Studies in Immune Checkpoint Inhibitor-related Adverse Events- SITC CPG Webinar
  • This high-level webinar will include case studies that illustrate execution of guideline recommendations, as well as discussion on difficult topics related to case management, as outlined in the Immune Checkpoint Inhibitor-related Adverse Events CPG. 

Mini-Modules:

• Autoimmune Disease
  • A case presentation of a patient with newly diagnosed metastatic non-squamous, non-small cell lung cancer who reports prior lupus is the jumping off point for an explanation from presenter Laura Capelli, MD, MHS, MS - Johns Hopkins University, on essential considerations for treating patients with pre-existing autoimmunity. 
• Special Patient Populations
  • This module features a discussion from faculty member David E. Gerber, MD - Harold C. Simmons Comprehensive Cancer Center, on immune-related adverse events in patients typically considered high-risk, specifically those with pre-exisiting autoimmune disease and transplant recipients.  Considerations for weighing risks versus benefits of checkpoint blockade in these patients are presented.
• Vaccines and Chronic irAEs
  • In the first section of this module, Laura Cappelli, MD, MHS, MS - Johns Hopkins University, describes data on antibody responses after vaccination in patients treated with immunosuppressive agents.  The second segment offers learners essential consideration for the management of chronic irAEs.