Dr. Mark G. Kris on Side Effects Management with Immunotherapies

Mark G. Kris, MD
Published: Friday, Oct 28, 2016


Mark G. Kris, MD, medical oncologist, William and Joy Ruane Chair in Thoracic Oncology, Memorial Sloan Kettering Cancer Center, discusses considerations for the management of immunotherapy toxicities.
 
With immunotherapy toxicities, virtually any organ system in the body can be affected. Oncologists are used to managing neutropenia, hair loss, and neuropathy, but there’s a whole spectrum of different side effects with immunotherapy, says Kris.It is important that oncologists are cognizant of them.

For example, it may be difficult for an oncologist with a patient on nivolumab to not run a complete blood count test on them, says Kris. However, this is not likely to be effective, he says.
 
What is needed for patients undergoing immunotherapy, is a thyroid function test. It is also important to watch blood sugar.

With immunotherapies, side effects are usually due to overactivity of the immune system. By stopping the drug and giving steroids and more potent immunosuppressive agents, the side effects can generally be controled. In many ways, the management of immunotherapy side effects is easier than the management of chemotherapy side effects, says Kris.

However, doctors have to learn a new vocabulary, a new set of skills, and enlist a lot of fellow specialist when using immunotherapies, he says. Endocrinologists and gastroenterologists are going to be critical in helping take care of these patients.
 

Mark G. Kris, MD, medical oncologist, William and Joy Ruane Chair in Thoracic Oncology, Memorial Sloan Kettering Cancer Center, discusses considerations for the management of immunotherapy toxicities.
 
With immunotherapy toxicities, virtually any organ system in the body can be affected. Oncologists are used to managing neutropenia, hair loss, and neuropathy, but there’s a whole spectrum of different side effects with immunotherapy, says Kris.It is important that oncologists are cognizant of them.

For example, it may be difficult for an oncologist with a patient on nivolumab to not run a complete blood count test on them, says Kris. However, this is not likely to be effective, he says.
 
What is needed for patients undergoing immunotherapy, is a thyroid function test. It is also important to watch blood sugar.

With immunotherapies, side effects are usually due to overactivity of the immune system. By stopping the drug and giving steroids and more potent immunosuppressive agents, the side effects can generally be controled. In many ways, the management of immunotherapy side effects is easier than the management of chemotherapy side effects, says Kris.

However, doctors have to learn a new vocabulary, a new set of skills, and enlist a lot of fellow specialist when using immunotherapies, he says. Endocrinologists and gastroenterologists are going to be critical in helping take care of these patients.
 



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