irAE Management for EC

CE / CME

Immune-Related Adverse Event Management and Supportive Care for Advanced Endometrial Cancer

ABIM MOC: maximum of 1.00 Medical Knowledge MOC point

Physicians: Maximum of 1.00 AMA PRA Category 1 Credit

Released: September 18, 2023

Expiration: September 17, 2024

Lauren Prescott
Lauren Prescott, MD, MPH
Ritu Salani
Ritu Salani, MD, MBA

Activity

Progress
1
Course Completed

References

  1. Wei SC, Duffy CR, Allison JP. Fundamental mechanisms of immune checkpoint blockade therapy. Cancer Discov. 2018;8:1069-1086.
  2. National Comprehensive Cancer Network. Clinical practice guidelines in oncology: management of immunotherapy-related toxicities. v.2.2023. nccn.org. Accessed September 1, 2023.
  3. Michot JM, Bigenwald C, Champiat S, et al. Immune-related adverse events with immune checkpoint blockade: a comprehensive review. Eur J Cancer. 2016;54:139-148.
  4. Martins F, Sofiya L, Sykiotis GP, et al. Adverse effects of immune-checkpoint inhibitors: epidemiology, management and surveillance. Nat Rev Clin Oncol. 2019;16:563-580.
  5. O'Malley DM, Bariani GM, Cassier PA, et al. Pembrolizumab in patients with microsatellite instability-high advanced endometrial cancer: results from the KEYNOTE-158 study. J Clin Oncol. 2022;40:752-761. 
  6. Oaknin A, Gilbert L, Tinker AV, et al. Safety and antitumor activity of dostarlimab in patients with advanced or recurrent DNA mismatch repair deficient/microsatellite instability-high (dMMR/MSI-H) or proficient/stable (MMRp/MSS) endometrial cancer: interim results from GARNET-a phase I, single-arm study. J Immunother Cancer. 2022;10:e003777.
  7. National Comprehensive Cancer Network. Clinical practice guidelines in oncology: uterine neoplasms. v.2.2023. nccn.org. Accessed September 1, 2023.
  8. Mirza MR, Chase DM, Slomovitz BM, et al. Dostarlimab for primary advanced or recurrent endometrial cancer. N Engl J Med. 2023;388:2145-2158.
  9. Eskander RN, Sill MS, Beffa L, et al. Pembrolizumab plus chemotherapy in advanced endometrial cancer. N Engl J Med. 2023;388:2159-2170.
  10. Mirza MR, Powell MA, Lundgren C, et al. Patient-reported outcomes (PROs) in primary advanced or recurrent endometrial cancer (pA/rEC) for patients (pts) treated with dostarlimab plus carboplatin/paclitaxel (CP) as compared to CP in the ENGOT-EN6/GOG3031/RUBY trial. Presented at: 2023 American Society of Clinical Oncology Annual Meeting; June 2-6, 2023. Abstract 5504.
  11. Viswanathan AK, Lee LJ, Eswara JR, et al. Complications of pelvic radiation in patients treated for gynecologic malignancies. Cancer. 2014;120:3870-3883.
  12. Gwede CK. Overview of radiation- and chemoradiation-induced diarrhea. Semin Oncol Nurs. 2003;19(4 suppl 3):6-10.
  13. Madden KM, Hoffner B. Ipilimumab-based therapy: consensus statement from the faculty of the melanoma nursing initiative on managing adverse events with ipilimumab monotherapy and combination therapy with nivolumab. Clin J Oncol Nurs. 2017;21(suppl 4):30-41.
  14. Schneider BJ, Naidoo J, Santomasso BD, et al. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: ASCO guideline update. J Clin Oncol. 2021;39:4073-4126.
  15. Ali S, Habib I. Pharmacological interventions for the prevention and treatment of radiation colitis, enteritis and proctitis. Cochrane Database Syst Rev. 2017;2017:CD008971.
  16. Wang Y, Abu-Sbeih H, Mao E, et al. Immune-checkpoint inhibitor-induced diarrhea and colitis in patients with advanced malignancies: retrospective review at MD Anderson. J Immunother Cancer. 2018;6:37.
  17. Association of Community Cancer Centers Immuno-Oncology Institute. Best practices for implementing cancer immunotherapy in the community. accc-cancer.org/docs/immuno-oncology/io-best-practices-for-implementing-cancer-immunotherapy-in-the-community. Accessed September 1, 2023.
  18. Lenvatinib [prescribing information]. Nutley, NJ: Eisai Inc.; 2022.
  19. US Food and Drug Administration. FDA grants regular approval to pembrolizumab and lenvatinib for advanced endometrial carcinoma. fda.gov/drugs/resources-information-approved-drugs/fda-grants-regular-approval-pembrolizumab-and-lenvatinib-advanced-endometrial-carcinoma. Accessed September 1, 2023.
  20. Makker V, Colombo N, Herráez AC, et al. Lenvatinib plus pembrolizumab for advanced endometrial cancer. N Engl J Med. 2022;386:437-448.
  21. Makker V, Colombo N, Herráez AC, et al. Lenvatinib plus pembrolizumab in previously treated advanced endometrial cancer: updated efficacy and safety from the randomized phase III study 309/KEYNOTE-775. J Clin Oncol. 2023;41:2904-2910.
  22. Makker V, Taylor MH, Oaknin A, et al. Characterization and management of adverse reactions in patients with advanced endometrial carcinoma treated with lenvatinib plus pembrolizumab. Oncologist. 2021;26:e1599-e1608. 
  23. Motzer R, Alekseev B, Rha ST, et al. Lenvatinib plus pembrolizumab or everolimus for advanced renal cell carcinoma. N Engl J Med. 2021;384:1289-1300. 
  24. Motzer R, George S, Merchan JR, et al. Characterization and management of adverse reactions from the CLEAR study in advanced renal cell carcinoma treated with lenvatinib plus pembrolizumab. Oncologist. 2023;28:501-509. 
  25. Pembrolizumab [prescribing information]. North Wales, PA: Merck, Sharp and Dohme Corporation, a subsidiary of Merck & Co., Inc.; 2023.
  26. Robinson ES, Khankin EV, Karumanchi SA, et al. Hypertension induced by VEGF signaling pathway inhibition: mechanisms and potential use as a biomarker. Semin Nephrol. 2010;30:591-601.
  27. Izzedine H, Massard C, Spano JP, et al. VEGF signalling inhibition-induced proteinuria: mechanisms, significance and management. Eur J Cancer. 2010;46:439-448.