Immune-related adverse events and the role of emerging risk factors

Overview of immune-related adverse events from cancer immunotherapies and the role of risk factors to identify patients at high risk of treatment-related harm.

BISHMA JAYATHILAKA
Pharmacist 
Peter Mac and Cancer Health Services Research group, UMCCR

Immune checkpoint inhibitors (ICI) have profoundly changed the treatment of cancer, in particular metastatic melanoma. Immune-related adverse events (irAE) continue to be a treatment-limiting barrier to the use of ICI. ICI work by blocking inhibitory immune pathways to promote T cell activity against tumour cells. As a result of reactivated cellular immunity, auto-immune toxicities can occur in various organ systems, including skin, gastrointestinal, endocrine, liver, lung and kidneys. Clinical, laboratory and patient characteristics that may increase irAE incidence and severity are emergingly reported in literature on ICI treatment in diverse cancer types.

This session will cover principles of T cell mediated immune responses, immune checkpoint pathways, mechanism of clinical effect and toxicity of immune checkpoint inhibitors, and the future direction of emerging risk factors that may play a role in identifying patients who are at risk of irAE.

Bishma Jayathilaka is a clinical pharmacist and Chief Pharmacy Information Officer at Peter MacCallum Cancer Centre. After completing a Bachelor of Pharmacy in New Zealand, she completed a Master of Public Health at the University of Melbourne and an internship at the WHO Headquarters in the Department of Health Innovation. Through her clinical work, Bishma has maintained an interest in cancer and has worked in paediatric and adult cancer in regional and metropolitan health services.

Bishma commenced a PhD in July 2021 under the joint supervision of Professor Maarten IJzerman, Dr George Au-Yeung, and Dr Fanny Franchini. Her research focuses on risk prediction of immune-related adverse events (irAE) and aims to identify irAE occurrence in real-world data. Ultimately, her research aims to inform the development and integration of irAE risk prediction into clinical cancer services.