Three recent reviews provide comprehensive recommendations for the management of cancer treatment-related toxicity, including the ESMO guideline on diagnosis, treatment, and follow-up for immunotherapy toxicity, recommendations for potential CDK 4/6 inhibitor-related toxicities and drug interactions in breast cancer, and an update to ASCO antiemetics guidelines.
- New ESMO Guideline on Diagnosis, Treatment, and Follow-up of Immunotherapy Toxicity. While immune checkpoint inhibitors have revolutionized the treatment of cancer, these agents are associated with a unique array of adverse events (AEs) that are mechanism-dependent and can impact treatment success if not managed properly. Any organ or tissue can be involved, although some immune-related AEs (irAEs) occur more often than others. Immune-related AEs can be relatively easy to manage if detected early. Close monitoring and appropriate use of steroids and secondary immune suppressive agents when indicated are key to effective and safe patient management. In this article, the European Society of Medical Oncology (ESMO) provides updated comprehensive clinical guidelines for the diagnosis and treatment of irAEs, including recommendations for patient baseline assessment for susceptibility to develop irAEs, appropriate diagnostic tools, and algorithms for treatment for each major class of irAEs. Ann Oncol. 2017;28(Suppl 4):iv119-iv142.
- Recommendations for Management of Potential CDK 4/6 Inhibitor-Related Toxicities and Drug Interactions in Breast Cancer. Cyclin-dependent kinase 4/6 (CDK 4/6) inhibitors in combination with hormone therapy have recently become a standard treatment for hormone receptor (HR)-positive and HER2-negative breast cancer based on their significant clinical benefit. This class of therapy is associated with a unique, but easily manageable toxicity profile, primarily comprised of hematologic toxicities, including neutropenia. This review summarizes the current literature regarding the safety and efficacy of CDK 4/6 inhibitors in HR-positive, HER2-negative breast cancer and discusses strategies to manage the toxicities and drug interactions associated with these agents. Oncologist. 2017 July 13. [Epub ahead of print]
- Update to ASCO Antiemetics Guidelines. The American Society of Clinical Oncology (ASCO) released updated recommendations to prevent and manage nausea and vomiting caused by anticancer systemic or radiation therapy. An expert panel updated the current guidelines based on a systemic review of 41 publications. Among notable recommendations are the addition of olanzapine to three drug antiemetic regimens for adult patients receiving high-emetic risk antineoplastic agents, the expanded use of neurokinin 1 (NK-1) receptor antagonists, and the addition of two new antiemetics: NK-1 inhibitor of rolapitant and subcutaneous granisetron. In addition, refinements of risk levels and recommendations for antiemetic therapy for radiation-induced nausea and vomiting and antiemetic regimens for pediatric populations are provided. The expert panel highlighted the importance of using the most effective antiemetic regimens for administered antineoplastic agents or radiotherapy when treatment is initiated. In addition, the panel indicated that current evidence is insufficient for recommending cannabinoids, such as medical marijuana for prevention of nausea and vomiting during cancer treatment. J Clin Oncol. 2017 July 31. [Epub ahead of print]