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Monitor Toxicities When Treating Breast Cancer With Immunotherapy

By Leisha A. Emens, MD, PhD

The combination of atezolizumab (Tecentriq) and nab-paclitaxel is approved for the treatment of patients with metastatic/advanced triple-negative breast cancer. However, the combination is not without adverse events, explained Leisha A. Emens, MD, PhD, professor of medicine in hematology/oncology, co-leader of the Hillman Cancer Immunology and Immunotherapy Program, and director of translational immunotherapy for the Women's Cancer Research Center (WCRC), at the UPMC Hillman Cancer Center.


Overall, therapy with atezolizumab and nab-paclitaxel was quite well tolerated. The main side effects are what you would expect with either agent alone.

With regard to immune-related adverse events, which with immunotherapy we always have to be vigilant for because some of them can be quite serious, we didn't actually see a whole lot of grade 3 to 4 immune-related adverse events. The rate of pneumonitis was on the order of 1%-3%. Hepatitis on the order of 1%. The main immune-related adverse event that we saw was low-grade hypothyroidism, grades 1-2. That's quite easily treatable with [ [levothyroxine (Synthroid)]. You just have to recognize the symptoms and then evaluate it with thyroid-function tests and then make the appropriate prescription for synthroid.

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