Page 72 - Helicobacter pylori and Gastric Cancer: From Tumor microenvironment to Immunotherapy

Adverse events
It is pertinent to note that immune-modulating agents can exert some levels of toxicity[21, 22] and anti-immuno-checkpoint therapy of gastric cancer is not an exception. Unfavorable event outcomes were seen in several clinical trials which can be managed by the administration of corticosteroids although it is an immunosuppressive agent. Colitis resulting from checkpoint inhibitor therapy is sometimes managed by infliximab, an anti-tumor necrosis factor alpha agent. At the latter compound provokes T cell apoptosis, this is probably detrimental and should be avoided[23]. In a clinical testing involving pembrolizumab and Avelumab, a five total grade drug-related adverse event was observed in four patients, including loss- of-appetite, fatigue, damage to peripheral nerves and peripheral ischemia. However, no fatalities as consequence of drug side-effects have been reported, and it is fair to say that although not little off-target effects can be efficiently clinically managed.
Conclusions
PD-1 inhibition is a useful clinical option for advanced gastric cancer patients failing other modes of treatment and performs better other forms of checkpoint inhibitor therapy in this disease and associated with acceptable toxicity. At present strategies to target anti-PD1 therapy to those patients most likely to benefit from such intervention based on tumor PD-L1 expression have largely failed. Hence the reason why only a minority of gastric cancer patients benefit from anti-PD1 therapy remain primarily obscure and require further investigation
Competing interests
No competing interests.
Acknowledgments
The authors acknowledge the doctoral research scholarship provided by the Federal Government of Nigeria (TETFUND) in conjunction with the Nasarawa State University, Keffi (NSUK), Nasarawa State. Nigeria.
Chapter 3
Chapter 3
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