SITC Spearheads Initiative for Management of Immunotherapy-Related Side Effects

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Igor Puzanov, MD, MSCI, FACP

Igor Puzanov, MD, MSCI, FACP

The first consensus recommendations on the recognition and clinical management of immune-related side effects from cancer immunotherapy were recently published in the Journal for ImmunoTherapy of Cancer (JITC).1 The article, “Managing Toxicities Associated With Immune Checkpoint Inhibitors: Consensus Recommendations From the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group,” is a key step toward ensuring patients with cancer receive the highest quality of care.

Clinical trials have shown that checkpoint inhibitors are highly effective, providing long-term benefit with generally manageable side effects. However, patterns are emerging to suggest that checkpoint inhibitors may cause unwanted effects in a number of organ systems.

When caught early, most of these side effects are mild and can be treated with drugs that temporarily suppress the immune system. Experts are therefore focused on ensuring that clinicians recognize and know how to manage these emerging side effects, so patients can continue to take advantage of the unquestionable benefits of immunotherapy.

Addressing an Unmet Need

As the leading professional society in the field, the Society for Immunotherapy of Cancer (SITC) established a multidisciplinary expert group to address this unmet need. Medical oncologists, surgeons, disease specialists, scientists, pharmacists, nurses, and others with relevant expertise convened to develop guidance on managing adverse effects from checkpoint inhibitors.

Medical oncologist Igor Puzanov, MD, MSCI, FACP, of Roswell Park Cancer Institute, Buffalo, New York, one of the four study co-leads, explained: “New immunotherapy agents are being approved at a rapid pace. We’re excited that patients have new treatment options, but many of these agents have side effects we haven’t seen before. We’re seeing effects on the skin, lungs, gastrointestinal and endocrine systems, joints, heart, and other organs, and some of them are only just beginning to be described. Clinicians need guidance on how to recognize early signs, how to treat adverse effects, and when to refer to a disease specialist.”

In addition to Dr. Puzanov, Marc Ernstoff, MD, also of Roswell Park Cancer Institute; Howard L. Kaufman, MD, FACS, of Massachusetts General Hospital; and Adi Diab, MD, of The University of Texas MD Anderson Cancer Center, are leading the SITC initiative and have made it a priority to align recommendations across organizations. 

This is a dynamic effort, and recommendations will evolve and be updated as new data—and new drugs and combinations—become available. ■

DISCLOSURE: For full disclosures of the study authors, visit


1. Puzanov I, Diab A, Abdaliah K, et al: Managing toxicities associated with immune checkpoint inhibitors: Consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group. J Immunother Cancer 5:95, 2017.




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