Podcast 577: Immunotherapies

Checkpoint inhibition normally helps our body detect abnormal cells and terminate it but cancerous cells often are able to avoid this countermeasure

Monoclonal antibodies that bind to checkpoint inhibitors can stop cancerous cells from turning off immunologic T cells and allows the immune system to continue to attack cancers.

These therapies carry risks of exacerbating autoimmune problems due to the ramped up immune response

Most often this autoimmune attack leads to skin and GI symptoms but can affect many other organ systems. In the emergency room this can present many different ways, but the mainstay of treatment is steroids to stop these exacerbations.

Chimeric Antigen Receptor (CAR) T-cell Therapy is another immunotherapy where antigens to a cancerous cell are re-introduced to spur a directed immune response

Cytokine release syndrome can occur in these patients and mimic other presentations such as septic shock, a result of tumor break down

This is treated with steroids and monoclonal antibodies that help thwart the cytokine release