J Rheum Dis 2019; 26(4): 221-234  
Immune-related Adverse Events: Overview and Management Strategies for the Use of Immune Checkpoint Inhibitors
Hei-Cheul Jeung, Se Eung Oh, Jee Hung Kim
Division of Medical Oncology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Correspondence to: Hei-Cheul Jeung http://orcid.org/0000-0003-0952-3679
Division of Medical Oncology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06237, Korea. E-mail : jeunghc1123@yuhs.ac
Received: April 15, 2019; Revised: July 4, 2019; Accepted: July 6, 2019; Published online: October 1, 2019.
© Korean College of Rheumatology. All rights reserved.

This is a open Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Recent studies on T cell immunology have been instrumental in developing therapies to overcome cancer immune escape, and immune checkpoint inhibitors have emerged as one of the most promising therapeutic tools in advanced cancer patients. Immune checkpoint inhibitors (ICPIs) are monoclonal antibodies that modulate the effects of immune checkpoints. These include cytotoxic T lymphocyte antigen 4 and programmed cell death protein 1, which are co-inhibitory signals responsible for immune suppression. Despite their clinical benefits, ICPIs behave as general immune activators, exerting to several toxic effects called immune-related adverse events attributed to organ-specific inflammation. Here, we review ICPI toxicities, highlighting the importance of their early identification and proper management.
Keywords: Immune checkpoint inhibitors, Immune-related adverse events, Adrenal cortex hormones, Programmed cell death protein 1, CTLA-4 antigen


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