Immunotherapy: Why Do Only Some MSI-High Tumors Respond?

‚ÄčResearchers report that they have found a solution to the puzzle of why some patients with microsatellite instability (MSI)-high tumors respond well to immune checkpoint inhibitors, whereas others do not. Tumors that have defects in DNA mismatch repair are unable to fix certain types of DNA damage. This leads to sequence alterations in the DNA's microsatellites (repetitive genetic sequences in which DNA motifs ranging in length from one to six base pairs are reiterated as many as 50 times). The...
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Novel Management Strategies for Immune-Related Pruritus: An Interview With Shawn Kwatra, MD

Shawn G. Kwatra, MD

Immunotherapies such as PD-1 inhibitors have improved survival for many patients with cancer. However, these therapies are associated with adverse events that, if not properly managed, impair quality of life and may lead to treatment interruptions or discontinuation. Pruritus is one of the most common immune-related adverse events, and while many cases may be managed with conventional therapy, some patients do not respond. Shawn Kwatra, MD and colleagues reported on a case of an 88-year-old woman receiving pembrolizumab, a PD-1 inhibitor, for metastatic lung adenocarcinoma who developed severe pruritus refractory to standard treatment. Dr. Kwatra and colleagues found that intravenous naloxone, an opioid antagonist, resulted in a reduction in pruritus severity from 10 to 1 (on a scale of 0 to 10) within 1 hour. i3 Health spoke with Dr. Kwatra, Assistant Professor of Dermatology at Johns Hopkins University School of Medicine, about his findings and the challenges, potential advances, and role of multidisciplinary care in the management of dermatologic immune-related adverse events.

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