HYPERSENSITIVITY REACTIONS AND ANAPHYLAXIS TO CHECKPOINT INHIBITOR-MONOCLONAL ANTIBODIES AND DESENSITIZATION.

Objective To review type-1 hypersensitivity reactions and anaphylaxis to checkpoint inhibitor-monoclonal antibodies, and its management with drug desensitization. Data Sources English language literature on Medline regarding hypersensitivity, anaphylaxis and checkpoint inhibitor-monoclonal antibodies. Study Selections References were selected based on relevance, novelty, robustness, and applicability. Results There are well known tissue toxicities associated to checkpoint inhibitors but hypersensitivity reactions and anaphylaxis have been underreported. The presentation of these reactions is based on clinical phenotypes with underlying endotypes identified by specific biomarkers. Drug desensitizations have been sucessfully applied to checkpoint inhibitor drugs to allow cancer patients to receive first-line therapies. This review provides current best practices for the recognition and diagnosis of hypersensitivity reactions and anaphylaxis to checkpoint inhibitors and their management using drug desensitization. Conclusion Hypersensitivity reactions and anaphylaxis have been identified as potential side effects induced by checkpoint inhibitor-monoclonal antibodies. Drug desensitization is a safe and effective treatment option for patients who suffer hypersensitivity reactions in need of these monoclonal antibodies to improve cancer outcomes.