Immunotherapy-related adverse reactions – Liver and lungs

This article describes liver and lung-related immunotherapy adverse reactions and their treatment methods.

What should I do if my skin or urine turns yellow?

Adverse liver reactions caused by immunotherapy, often manifested as yellowing of the skin/eyes, yellowing of urine, nausea and vomiting, fatigue, etc., usually occur 8 to 12 weeks after the first immunotherapy.

Immunotherapy-associated liver adverse effects have a relatively good prognosis and can be improved with symptomatic therapy, with less liver failure and death, and most patients recover liver function levels within 1 to 3 months. Therefore, before receiving initial immunotherapy, patients should actively undergo liver function tests to understand and check for underlying liver diseases.

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If there are corresponding symptoms, we should promptly report to the medical staff and consult a doctor, and the doctor will treat it accordingly according to different severity.

To prevent liver adverse reactions caused by treatment, we can do the following:

1. Regular monitoring of liver function

If the test results are abnormal (eg, elevated alanine and/or aspartate aminotransferase, with or without elevated bilirubin), contact your healthcare provider promptly.

2. Pay attention to daily diet

In terms of daily diet, eat more vitamin-rich foods (such as fruits, vegetables, etc.) and avoid high-fat foods (such as fried foods, fatty meats, etc.).

What should I do if I have difficulty breathing or coughing?

Symptoms such as dyspnea, cough, and chest pain may be manifestations of immunotherapy-related pneumonia, and should not be ignored.

Immunotherapy-associated pneumonia is a rare but life-threatening serious adverse event that occurs relatively late, usually around 3 months after treatment is started.

Of all cases of immunotherapy-associated pneumonia, the majority (72%) of patients are grade 1-2 and can be improved by treatment with hormones or immunosuppressants. If the above lung symptoms or the original symptoms worsen, it is necessary to go to the hospital in time to avoid missing the best time for treatment.

It's worth noting that it's not that you don't have to worry without symptoms!

About one-third of patients are asymptomatic and have only radiographic abnormalities. Therefore, it is recommended to go to the hospital regularly for follow-up visits for lung imaging, especially in the elderly, asthma, chronic obstructive pulmonary disease or other patients with symptoms of cardiopulmonary disease should pay special attention.

The above is the liver and lung adverse reactions that may be caused by immunotherapy, in the process of immunotherapy, remember to do a good job of prevention Oh ~

bibliography:

Guidelines Working Committee of Chinese Society of Clinical Oncology. Chinese Society of Clinical Oncology (CSCO) Guidelines for Toxicity Management Related to Immune Checkpoint Inhibitors 2021.People's Medical Publishing House

Qin Shukui. Wang Baocheng is the editor-in-chief of the Patient Education Manual for Adverse Reactions Related to Tumor Immunotherapy (2020).