Dr. Chaft on Considerations for Restarting Immunotherapy in Lung Cancer

Jamie E. Chaft, MD, a thoracic medical oncologist at Memorial Sloan Kettering Cancer Center, discusses considerations for restarting immunotherapy in patients with lung cancer.

It was once believed that all immune-related adverse events (IRAEs) were solely T-cell mediated. Now, it’s widely understood that not all IRAEs are created equal, says Chaft; some of these events may be T-cell mediated while others, such as thyroiditis, may be B-cell mediated. Others can experience cytokine-mediated events.

Since IRAEs are not created equal, they should be managed on an individualized basis, adds Chaft. Each event has a different level of severity and duration of impact on patients. IRAEs require a different level of consideration when determining whether to restart immunotherapy in a patient, explains Chaft.

These events need to be thoroughly evaluated and intervened upon to prevent harm to the patient. One of the most common interventions is either topical or systemic corticosteroids. Sometimes, steroid-sparing agents are used to prevent steroid-induced AEs, such as osteoporosis and gastritis, concludes Chaft.