• Kapil Agarwal, Nadia Yousaf, and Daniel Morganstein.
• Imperial College, London, UK.
• Clin Med (Lond). 2020 Mar 1; 20 (2): 163168163-168.

BackgroundImmune checkpoint inhibitors have demonstrated benefit in the treatment of cancer, but are associated with toxicities, which often require treatment with glucocorticoids.AimsWe aimed to determine the prevalence of glucocorticoid use in patients treated with immune checkpoint inhibitors for melanoma in a single centre.MethodsWe performed a retrospective review of patients with advanced melanoma treated with an immune checkpoint inhibitor between September 2010 and January 2017. Patients treated with glucocorticoids had a cumulative dose and duration of glucocorticoid treatment calculated. New onset hyperglycaemia was also identified.ResultsOf 412 patients receiving immune checkpoint therapy, 157 (38%) required glucocorticoids to treat toxicities. The median cumulative glucocorticoid dose was 2,795 mg (prednisolone equivalent) with a median duration of 61 days. Twenty-seven patients receiving glucocorticoids were noted to develop new onset hyperglycaemia.ConclusionsImmune-related adverse events frequently occur in patients treated with immune checkpoint inhibitors. Consequently, patients receive prolonged courses of glucocorticoids. Awareness of glucocorticoid-induced side effects is required.© Royal College of Physicians 2020. All rights reserved.

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