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Review
. 2016 Aug;13(8):473-86.
doi: 10.1038/nrclinonc.2016.58. Epub 2016 May 4.

Safety profiles of anti-CTLA-4 and anti-PD-1 antibodies alone and in combination

Celine Boutros  1 , Ahmad Tarhini  2 , Emilie Routier  1 , Olivier Lambotte  3   4   5 , Francois Leroy Ladurie  6 , Franck Carbonnel  4   7 , Hassane Izzeddine  8 , Aurelien Marabelle  9 , Stephane Champiat  10 , Armandine Berdelou  11 , Emilie Lanoy  12 , Matthieu Texier  12 , Cristina Libenciuc  1 , Alexander M M Eggermont  1   4 , Jean-Charles Soria  4   9   10 , Christine Mateus  1 , Caroline Robert  1   4   10
Affiliations
Review

Safety profiles of anti-CTLA-4 and anti-PD-1 antibodies alone and in combination

Celine Boutros et al. Nat Rev Clin Oncol. 2016 Aug.

Abstract

Inhibition of immune checkpoints using anti-programmed cell death-1 (PD-1) or anti cytotoxic-T-lymphocyte-associated antigen 4 (CTLA-4) monoclonal antibodies has revolutionized the management of patients with advanced-stage melanoma and is among the most promising treatment approaches for many other cancers. Use of CTLA-4 and PD-1 inhibitors, either as single agents, or in combination, has been approved by the US FDA for the treatment of metastatic melanoma. Treatment with these novel immunotherapies results in a unique and distinct spectrum of adverse events, which are mostly related to activation of the immune system and are, therefore, an unwanted consequence of their mechanisms of action. Adverse effects of CTLA-4 and/or PD-1 inhibition are most commonly observed in the skin, gastrointestinal tract, liver and endocrine systems and include pruritus, rash, nausea, diarrhoea and thyroid disorders. In this Review, the authors describe the adverse event profile of checkpoint inhibitors targeting CTLA-4 and PD-1, used both as monotherapies and in combination and aim to provide some general guidelines, based upon the mechanisms of action of these therapies and on the management of these immune-related adverse events.

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