Cancer Immunotherapy Toxicity Evaluation

Understanding immunotherapy side effects

Immunotherapies, such as checkpoint inhibitors, work by disabling the "off switches" on immune cells, allowing them to attack cancer cells. In some cases, however, immune cells attack healthy cells and cause side effects called immune-related adverse events (irAEs). Up to 79% of people experience irAEs depending on their cancer type and treatment.

If you're experiencing these symptoms, it's important to get a prompt assessment, diagnosis and treatment to prevent serious or life-threatening complications. Steroids and immunosuppressants (drugs that calm the immune system) are common treatments for irAEs.

If severe complications develop and we recommend temporarily stopping cancer treatment, we help you safely restart immunotherapy when the time is right. Our experts use the newest, evidence-based approaches to prevent or minimize interruptions in immunotherapy treatment.

At our CITE program, a dedicated practice coordinator streamlines your care and arranges for all necessary tests, procedures and subspecialty consultations. Our team collaborates with experts in cardiology, nephrology, hepatology, hematology, pulmonology, neurology and many other clinical areas at UCSF Health to ensure your needs are met.

Symptoms of immunotherapy toxicity

Symptoms of irAEs can develop at any time during immunotherapy treatment or even after treatment.

Toxicity symptoms may affect your:

• Eyes. Dry eyes, changes to your vision, or eye pain and swelling

• Heart. Shortness of breath, chest pain, fainting or irregular heartbeat

• Kidneys. Frequent urination, swollen face and limbs, fatigue or appetite changes

• Liver. Jaundice (yellow skin), dark urine, abdominal pain or nausea

• Lungs. Chest pain, cough, wheezing or breathlessness

• Nerves. Numbness or tingling in your limbs, seizures or cognitive changes (thinking or memory changes)

• Skin. Itchy skin, rash, eczema or hair loss

Complications can also affect systems in your body, such as your:

• Blood. Fatigue, weakness, shortness of breath or pale skin

• Bones and muscles. Joint pain and stiffness or muscle weakness

• Digestive system. Nausea, diarrhea, abdominal pain or difficulty swallowing

• Endocrine system. Weight gain or loss, headaches, insomnia or intolerance to cold or heat