Corticosteroid Treatment Challenges in Patients with Immunotherapy-Related Toxicities

EP: 1.An Overview of the Landscape Surrounding Melanoma

EP: 2.The Role of Biomarker Testing in Melanoma

EP: 3.The Current Landscape Surrounding Adjuvant Therapy in Melanoma

EP: 4.Combination Immunotherapy Strategies for Melanoma in the Adjuvant Setting

EP: 5.Navigating Challenges in Predicting and Mitigating Adverse Events in Adjuvant Immunotherapy

EP: 6.Exploring Immunotherapy Resistance: Impact on Treatment Decisions in Melanoma

EP: 7.Balancing Quality of Life: Adjuvant Therapy Toxicity in Melanoma Adjuvant Immunotherapy

EP: 8.Case 1: Man Aged 55 Years With Stage IIIB Melanoma Developing Immunotherapy-Induced Diabetes

EP: 9.Immunotherapy-Related Diabetes in Melanoma: A Management Perspective

EP: 10.Immunotherapy-Induced Adrenal Insufficiency in Melanoma: Surveillance and Management

EP: 11.Case 2: 63-Year-Old Female Patient With Metastatic Melanoma on Dual Immunotherapy Developing Treatment-Related Myocarditis

EP: 12.Approaches to Diagnosing and Managing Myocarditis Related to Immunotherapy

EP: 13.Expert Perspectives on Cardiac Baseline and Surveillance Testing in Immunotherapy Recipients

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EP: 14.Corticosteroid Treatment Challenges in Patients with Immunotherapy-Related Toxicities

EP: 15.Forward Outlook and Clinical Insights in Melanoma Treatment

This is a video synopsis/summary of an OncLive Insights involving Afreen Shariff, MD, MBBS; Javid Moslehi, MD; and Nikhil Khushalani, MD.

Dr Shariff asks about managing steroid-refractory immune-related adverse events. Dr Khushalani states that for most grade 3 to 4 immune-related adverse events requiring intravenous steroids, his threshold to add another agent like infliximab or mycophenolate is low if there is no response in 48 to 72 hours. While most toxicity resolves with a steroid taper over 4 to 6 weeks, some patients relapse when tapering and require additional immunosuppression.

Regarding optimal steroid dosing, Dr Moslehi notes recent data in nearly 1000 myocarditis patients showed no outcomes difference between high-dose (>2 mg/kg per day) and low-dose (<1 mg/kg per day) regimens. The panel agrees balancing efficacy against long-term toxicity risk with prolonged high-dose steroids is challenging. Dr Shariff concludes it can be difficult to distinguish adrenal insufficiency symptoms from immune-related adverse events when tapering patients off steroids.

Video synopsis is AI-generated and reviewed by OncLive^® editorial staff.