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Immunotherapy toxicities

Immunotherapy toxicities Dr Fiona Taylor Outline Understand toxicities Key steps to safely using and Anticipate toxicities achieving the most benefits from immunotherapies for patients Manage toxicities immunotherapies are novel agents Increasing use NICE/CDF approved Clinical Trials Therefore more likely to encounter patients with Immunotherapy toxicities On the wards, in clinics, calling the hotline . toxicities may become more complicated Combination with chemotherapy, radiotherapy and other immunotherapies Patient assessment How are you going to assess a patient commencing Immunotherapy ? Baseline assessment Clinical PS 0 or 1 or 2. Co-morbidities Autoimmune diseases Medications prednisolone, potential drug interactions Bloods FBC U+E LFTs Blood borne viruses HIV, Hep B and C. Quantiferon test active or latent TB. Baseline hormone/endocrine profile FSH, LH, oestradiol/testosterone prolactin 9am cortisol, ACTH.

Immunotherapies work to activate the immune system against cancer •Toxicities occur because the immune system attacks Zself [ •Results in inflammation and dysfunction •Hence tend to exclude patients with pre-exisiting autoimmune conditions where there is already a condition present that attacks self

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