Corrections to “Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
Ann Oncol 2017; 28: iv119–iv142 (doi:10.1093/annonc/mdx225) Under the section “Gastrointestinal toxicity: Gastrointestinal toxicity of anti-CTLA4 antibodies: Diagnosis” The sigmoid colon and the rectum are involved in most cases; therefore, a flexible sigmoidoscopy is generally sufficient to make the diagnosis of anti-CTLA4-induced enterocolitis [38]. Is replaced with: The sigmoid colon and the rectum are involved in most cases; therefore, a flexible sigmoidoscopy is generally sufficient to make the diagnosis of anti-CTLA4-induced enterocolitis [38, 42]. Under the section “Gastrointestinal toxicity: Gastrointestinal toxicity of anti-CTLA4 antibodies: Management” Overall, one-third to two-thirds of patients either do not respond to high-dose i.v. steroids, or have a relapse requiring an increase in the corticosteroid dosage during the course of steroid tapering. These patients require infliximab and usually have an excellent response. A single dose of infliximab (5mg/kg) is generally sufficient [18, 35, 36, 38]. Is replaced with: Overall, one-third to two-thirds of patients either do not respond to high-dose i.v. steroids, or have a relapse requiring an increase in the corticosteroid dosage during the course of steroid tapering [38, 42]. These patients require infliximab and usually have an excellent response. A single dose of infliximab (5mg/kg) is generally sufficient [18, 35, 36, 38, 42]. Figures The following changes apply as shown in the updated version below. In “Figure 8. ICPi-related toxicity: management of diarrhoea and colitis” Mild (G1): i.e. < 3 liquid stools per day over baseline, feeling well ICPi can be continued Is replaced with: Mild (G1): i.e. < 4 liquid stools per day over baseline, feeling well ICPi can be continued Severe (G3/4): i.e. > 6 liquid stools per day over baseline or if episodes within 1h of eating Requires hospitalisation and isolation until infection excluded ICPi to be withheld Is replaced with: Severe (G3/4): i.e. ≥ 7 liquid stools per day or life-threatening Requires hospitalisation and isolation until infection excluded ICPi to be withheld Below “Figure 9. ICPi-related toxicity: management of pneumonitis” Ab, antibody; Is replaced with: Ab, antibiotic; Under the section “Acknowledgements” We thank Prof. M. Gore and Dr L. Spain from the Royal Marsden Hospital, London, UK, for their help with developing the up-to-date AE management algorithms. Is replaced with: We thank Prof. M. Gore and Dr L. Spain from the Royal Marsden Hospital, London, UK, for their help with developing the up-to-date AE management algorithms. Dr Spain provided the irAE management algorithms for this article. Under the section “References” A new reference is added: 42. Verschuren EC, van den Eertwegh AJ, Wonders J et al. Clinical, endoscopic and histologic characteristics of ipilimumab-associated colitis. Clin Gastroenterol Hepatol 2016; 14: 836–842. 49. Weber JS, D'Angelo SP, Minor D et al. Nivolumab versus chemotherapy in patients with advanced melanoma who progressed after anti-CTLA-4 treatment (CheckMate 037): a randomised, controlled, open-label, phase 3 trial. Lancet Oncol 2015; 16: 375–384. Is replaced with: 50. Weber JS, Gibney G, Sullivan RJ et al. Sequential administration of nivolumab and ipilimumab with a planned switch in patients with advanced melanoma (CheckMate 064): an open-label, randomised, phase 2 trial. Lancet Oncol 2016; 17: 943–955. September 2018 When the above changes were made, Figure 6 was accidentally replaced with Figure 8 in the original article. This has now been corrected back. The Publisher apologizes for the error. Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-upAnnals of OncologyVol. 28PreviewImmunotherapy with monoclonal antibodies (MoAbs) targeting cytotoxic T lymphocyte-associated antigen 4 (CTLA4) and the programmed death-1 receptor (PD-1) and its ligand PD-L1 has become standard of care for an increasing number of indications (Table 1). Therefore, an increasing number of patients will be exposed to these drugs with a chance of developing toxicities from these treatments. Depending on the immune checkpoint that is targeted, the incidence of toxicity varies. Toxicities from immune checkpoint inhibitors (ICPis) can be divided into infusion reactions and immune-related adverse events (irAEs) or adverse events of special interest (AEoSI). Full-Text PDF Open Archive