Patients treated with new immunotherapies for cancer in the ICU
Over the last two decades, survival rates in patients with solid tumors and hematological malignancies have greatly improved. Molecular targeted therapy and cell therapy have improved disease-control, but their related life-threatening adverse events often require critical care management.
Although generally well tolerated compared to chemotherapy, molecular targeted therapy is associated with a 1% incidence of severe toxicity, mostly related to anti-angiogenic agents (for gastrointestinal and cardiovascular complications).
Critical care management plays an important role in patients receiving CARTs (Chimeric Antigen Receptor T cells), as up to half of patients might need an admission to the ICU and lifesaving interventions. Informing clinicians about clinical features of these toxic events may maintain awareness and favour early recognition, prompt diagnosis and treatment.
|Elie Azoulay is Professor of Medicine, Specialty Pulmonary Medicine at the Paris Diderot University and Critical Care Director of the Medical ICU of the Saint Louis Teaching Hospital, Paris (France).
He was Editor-in-Chief of Intensive Care Medicine from 2013-2018 and past Chairman of the ESICM Ethics Section.Prof. Azoulay is Director of the French FAMIREA study group, a multicentre collaborative multidisciplinary group aimed at improving effectiveness of communication with family members of ICU-patients. He directs the research group on the management of acute respiratory failure and outcomes in critically ill immunocompromised patients (Grrr-OH), and the OUTCOMREA research group on care quality and nosocomial infections.
His key areas of research include Acute Respiratory Failure (ARF), ICU management of immunocompromised patients and communication in the ICU. He also has a special interest in acute complications in patients with systemic vasculitis or connective tissue diseases.
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