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While the emergence of immunotherapy as an anti-cancer treatment is exciting, it’s increasing utilisation across tumour sites raises some concerns about our ability to manage the unfamiliar toxicities experienced from this therapy. In oncology we are continually learning as our clinical practice increases with these patients but typically patients will present to their district general hospital or general practitioner in the interim and potential toxicities may go unrecognised. Any organ or tissue can be involved, more commonly affecting skin, colon, endocrine organs, liver and lungs, however infrequent and potentially lethal adverse effects can also result, for example in neurological disorders or myocarditis. Patients are educated however the understanding of this complex therapy cannot be assumed. We have a responsibility to sign post resources and educate our colleagues in the community plus general medicine to aid recognition of a toxicity, which should then prompt liaison with specialist oncology services to guide management.1 Mismanagement of immunotherapy toxicities could potentialy be life threatening.
1. Authors: J. Haanen, F. Carbonnel, C. Robert, K. Kerr, S. Peters, J. Larkin and K. Jordan
Management of Toxicities from Immunotherapy: ESMO Clinical Practice Guidelines
Ann Oncol (2017) 28 (suppl 4): iv119–iv142.