Table 2 Summary of recommendations to managing immune-related adverse events. IrAEs: immune-related adverse events; IMP: investigational medicinal product
irAE | Supportive Care Intervention |
|---|---|
Grade 1 | Provide symptomatic treatment |
Grade 2 | Consider systemic corticosteroids in addition to appropriate symptomatic treatment. Steroid taper should be considered once symptoms improve to Grade 1 or less and tapered over at least 4 weeks. |
Grade 3 and Grade 4 | Systemic corticosteroids are indicated in addition to appropriate symptomatic treatment. May utilize 1 to 2 mg/kg prednisone or equivalent per day. Steroid taper should be considered once symptoms improve to Grade 1 or less and tapered over at least 4 weeks. Consider referral to organ-specific specialist (i.e. gastroenterologist, hepatologist, respiratory physician, endocrinologist) for any grade 3–4 irAEs, in order to evaluate substitution treatments and immune-modulating agents, such as anti-TNFα of other immune suppressants. |