Peritoneal mesothelioma is a rare and aggressive cancer that affects the lining of the abdomen. Treatment options for peritoneal mesothelioma include surgery, chemotherapy, and radiation therapy. In recent years, a new class of drugs called checkpoint inhibitors has shown promise in the treatment of various types of cancer, including mesothelioma. However, as with any cancer treatment, there are potential side effects that patients should be aware of.
Checkpoint inhibitors are a type of immunotherapy that work by blocking certain proteins on the surface of immune cells, called checkpoints, that prevent the immune system from attacking cancer cells. By blocking these checkpoints, checkpoint inhibitors can help the immune system recognize and attack cancer cells more effectively.
There are several checkpoint inhibitors that have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of various types of cancer, including pembrolizumab (Keytruda), nivolumab (Opdivo), and ipilimumab (Yervoy). While these drugs have shown promise in clinical trials, they can also cause side effects.
Common side effects of checkpoint inhibitors include fatigue, rash, diarrhea, and nausea. These side effects can usually be managed with medications or other supportive care measures. However, checkpoint inhibitors can also cause more serious side effects, known as immune-related adverse events (irAEs).
IrAEs occur when the immune system attacks healthy tissues in the body, leading to inflammation and other symptoms. The severity of irAEs can range from mild to life-threatening, and they can affect any organ system in the body. Some of the most common irAEs associated with checkpoint inhibitors include:
Skin reactions: Checkpoint inhibitors can cause a range of skin reactions, from mild rashes to more serious conditions like Stevens-Johnson syndrome and toxic epidermal necrolysis. These conditions can cause blistering, peeling, and other symptoms, and may require hospitalization and treatment with high-dose steroids.
Gastrointestinal reactions: Checkpoint inhibitors can cause inflammation of the digestive tract, leading to symptoms like diarrhea, abdominal pain, and nausea. In severe cases, this can lead to bowel perforation or other complications that require hospitalization.
Liver toxicity: Checkpoint inhibitors can cause inflammation of the liver, which can lead to elevated liver enzymes, jaundice, and other symptoms. In severe cases, this can lead to liver failure and the need for hospitalization.
Endocrine disorders: Checkpoint inhibitors can affect the function of the endocrine system, which includes the thyroid gland, pituitary gland, and adrenal glands. This can lead to conditions like hypothyroidism, hyperthyroidism, and adrenal insufficiency, which may require treatment with hormone replacement therapy.
Lung inflammation: Checkpoint inhibitors can cause inflammation of the lungs, which can lead to symptoms like cough, shortness of breath, and chest pain. In severe cases, this can lead to respiratory failure and the need for hospitalization.
It’s important for patients receiving checkpoint inhibitors to be monitored closely for signs of these and other potential side effects. In some cases, treatment with checkpoint inhibitors may need to be temporarily or permanently discontinued if side effects are severe or life-threatening.
In conclusion, checkpoint inhibitors are a promising new class of drugs for the treatment of peritoneal mesothelioma and other types of cancer. However, like any cancer treatment, there are potential side effects that patients should be aware of. Patients receiving checkpoint inhibitors should be monitored closely for signs of side effects, and should report any new or worsening symptoms to their healthcare provider right away.
