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Side Effects of Systemic Therapy and Their Clinical Management

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Melanoma

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Abstract

Understanding when to interrupt or permanently discontinue systemic therapy in patients with advanced melanoma is dependent on the class of therapy, type of adverse event, and severity. Criteria for resuming therapy following adverse events differs among drug classes. While patients can be re-challenged with reduced doses of BRAF and MEK inhibitors after improvement or resolution of toxicities, grade 2 or higher immune related adverse events (irAEs) associated with immune checkpoint inhibitor therapy usually requires drug interruption or discontinuation and upfront corticosteroids. This chapter will discuss toxicities of BRAF-targeted therapy, current immune checkpoint inhibitors, and injectable oncolytic viral therapy as well as toxicity management guidelines. The toxicities associated with targeted and immune checkpoint inhibitor therapies in patients with advanced melanoma present unique challenges to providers and patients.

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Authors and Affiliations

  1. Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC, USA

    Suthee Rapisuwon & Geoffrey T. Gibney

  2. Division of Hematology/Oncology, Medstar-Georgetown University Hospital, Washington, DC, USA

    Geoffrey T. Gibney

  3. Department of Oncology, Georgetown University, Washington, DC, USA

    Suthee Rapisuwon

Authors
  1. Suthee Rapisuwon
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  2. Geoffrey T. Gibney
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Corresponding author

Correspondence to Geoffrey T. Gibney .

Editor information

Editors and Affiliations

  1. Harvard/MGH Cutaneous Biology Research C Massachusetts General Hospital, Boston, Massachusetts, USA

    David E. Fisher

  2. Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    Boris C. Bastian

Section Editor information

  1. Henri and Belinda Termeer Center for Targeted Therapies, MGH Cancer Center, Boston, MA, USA

    Keith T. Flaherty

  2. UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA

    Boris C. Bastian

  3. Auburndale, MA, USA

    Hensin Tsao

  4. Harvard-MIT Health Sciences and Technology, Cambridge, MA, USA

    Hensin Tsao

  5. Framingham, MA, USA

    F. Stephen Hodi M.D.

  6. Department of Medicine, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA

    F. Stephen Hodi M.D.

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Rapisuwon, S., Gibney, G.T. (2018). Side Effects of Systemic Therapy and Their Clinical Management. In: Fisher, D., Bastian, B. (eds) Melanoma. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7322-0_22-1

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  • DOI: https://doi.org/10.1007/978-1-4614-7322-0_22-1

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