Guidelines Planned on Management of Immunotherapy Side Effects: ASCO and NCCN to Collaborate on Development

Guidelines Planned on Management of Immunotherapy Side Effects: ASCO and NCCN to Collaborate on Development

Dr. Clifford A. Hudis
Given the pace of advances in immunotherapy in recent years and physicians’ need to keep up with these developments, the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network® (NCCN®) announce a joint collaboration to publish practical clinical guidance on the management of side effects caused by immunotherapy.  

Through this novel collaboration, two of the leading providers of clinical practice guidelines in oncology aim to rapidly support improved quality of care for the growing number of patients receiving immunotherapy treatment for cancer.

Immunotherapy is increasingly identified as the best option for a growing number of cancers, many of which were previously intractable. The greatest success so far has been with immune checkpoint inhibitors and the U.S. Food and Drug Administration (FDA) has approved 15 indications for these agents over the last five years. Immunotherapy usage is likely to increase as we recognize encouraging results with several other specific classes of agents.

As with all therapies, there are both common and rare toxicities that clinicians need to consider when using immunotherapies. Clinicians may need guidance to recognize and optimally manage the novel and sometimes unique side effects caused by this relatively new type of treatment.    

“We have an opportunity to better serve our members and the entire oncology community by collaborating between ASCO and NCCN to rapidly produce this guideline that addresses an issue that is new for many clinicians,” said Clifford A. Hudis, MD, FASCO, FACP, ASCO Chief Executive Officer. “ASCO and NCCN share the common goal of high-quality patient care, and we look forward to working together to improve the quality of care for the millions of people affected by cancer.”

“In this age of rapid innovation in cancer care and introduction of novel immunotherapies, NCCN and ASCO recognize the crucial need to support physicians’ decision-making through publication of timely, evidence-based clinical guidelines,” said Robert W. Carlson, MD, Chief Executive Officer, NCCN. “We anticipate that, through our common mission, the collaboration between NCCN and ASCO indeed will improve the lives of patients with cancer.”

The side effects of immunotherapy are generally mild and infrequent, but when they do occur, they can be serious and even life threatening if not identified and treated in a timely manner.  The commonly known immune-mediated side effects include:

  • Pneumonitis
  • Colitis
  • Hepatitis
  • Adrenal insufficiency
  • Rash
  • Hyper/hypothyroidism
  • Hypophysitis
  • Renal insufficiency

As these immune-mediated side effects are often different from the side effects associated with other traditional cancer treatments, it is important that clinicians know how to recognize and manage them. 

Working together, each organization will use its standard methodology to develop and publish clinical practice guidelines under the lead of a multidisciplinary expert panel. At time of completion, two separate guidelines will be published: ASCO systemic review-based guideline and NCCN algorithmic guidelines. These guidelines are expected later this year.