Toxicity management in melanoma | 45 min 1

Cancer drugs have rapidly evolved in the last decade. Alongside the significant benefits are new toxicity profiles that clinicians need to be aware of and manage.

In this podcast, A/Prof Carlino interviews fellow Medical Oncologist Prof Georgina Long AO on the adverse events/toxicities associated with targeted therapies (combination BRAF/MEK inhibitors) and immunotherapies (anti-PD-1, anti-LAG-3 and anti-CTLA-4), particularly in melanoma, and how they should be managed.

Some key points brought up during this deep dive in toxicity:

• With targeted therapies, cessation of treatment usually reverses the toxicity.
• Immunotherapy toxicities are driven by the immune system rather than the drugs themselves, and as such, cessation of treatment does not automatically resolve toxicity. Most toxicities need active treatment to resolve.
• It is crucial to educate your patients regarding temporarily ceasing therapy in response to toxicity, particularly fever.
• It is important to recognise that immunotherapy toxicity is not necessarily treated the same as the autoimmune disease it may mimic.
• Understanding the patient’s history is crucial to identify if symptoms are a direct result of treatment.
• Ceasing immunotherapy treatment in the setting of toxicities does not mean you lose efficacy.
• It is important to understand the risk versus benefit when assessing your patient for re-challenge with immunotherapy after a toxicity.
• Medical Oncologists should have a referral network of experts for managing your patient’s toxicities.

• Module1.1
  Toxicity management in melanoma | 45 min
  45 min