Balancing Treatment Benefits and Risks of Severe Adverse Effects of Immunotherapy in Cancer: A Systematic Review
Zachrieh Alhaj *
Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, 77555, United States.
Zaid Almubaid
Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, 77555, United States.
Nada Alhaj
College of Pharmacy, University of Houston, Houston, Texas, 77004, United States.
Mohammed Omar Almosa
Edward Via College of Osteopathic Medicine, University of Louisiana Monroe, Monroe, Louisiana, 71203, United States.
Abdulkader Almosa
Department of Biology, Texas Tech University, Lubbock, Texas, 79409, United States.
Selma Abdurrahman
Department of Internal Medicine, Houston Methodist, Houston, Texas, 77030, United States.
*Author to whom correspondence should be addressed.
Abstract
Background: Melanoma has shown resistance to conventional treatments, resulting in poor prognoses. Recent advancements in immunotherapy have improved patient outcomes. However, these therapies are associated with severe adverse reactions, raising concerns about their safety.
Methods: A systematic review was conducted to evaluate the incidence and severity of adverse effects in melanoma patients undergoing immunotherapy compared to those receiving standard chemotherapy. Literature was sourced from Ovid Medline, CINAHL, and Scopus. After screening, 14 articles were selected based on inclusion and exclusion criteria.
Results: The review revealed that ICIs are linked to a higher incidence of severe adverse events compared to traditional therapies. Of the included studies, six focused on severe reactions to ICIs, while others discussed general toxicities, risk factors, management strategies, and potential predictive tools. Notably, findings indicated that approximately 25.1% of patients treated with ICIs experienced immune-related adverse events.
Conclusion: While ICIs have improved melanoma treatment, the increased risk of severe adverse reactions poses significant clinical challenges. Future research should focus on identifying mechanisms underlying these severe reactions and developing predictive tools.
Keywords: Cancer, immunotherapy, immune checkpoint inhibitors, adverse reactions