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Comment & Response
July 6, 2021

Immune Checkpoint Inhibitor Therapy Toxicities

Author Affiliations
  • 1Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
  • 2Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
  • 3Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania
JAMA. 2021;326(1):87. doi:10.1001/jama.2021.6030

To the Editor A recent JAMA Clinical Guidelines Synopsis discussed the management of immunotherapy-related toxicities in patients treated with immune checkpoint inhibitors, summarizing guidelines issued by the National Comprehensive Cancer Network (NCCN) in December 2019. However, the synopsis by Dr Reid and colleagues1 failed to address fatigue, one of the most common adverse effects of immune checkpoint inhibitors. Fatigue, which has been reported as an adverse event in up to 42% of patients being treated in a therapeutic clinical trial,2 can also present as a symptom of other immune-related adverse events such as endocrine dysfunction. A recent collaboration with the GO2 Foundation for Lung Cancer found that among participants in their registry treated with an immune checkpoint inhibitor, 85% retrospectively reported fatigue, with 41% experiencing moderate to severe fatigue.3