NorthWest Biotherapeutics Inc (NWBO)

[longfellow95]

Yes, it's truly remarkable how the ICI's have the ability to cause adverse events in just about every system of the body, requiring the intervention of doctors from nearly all medical specialties.

Some occur after 1 dose. Some occur years later.

Nobody yet knows just how effective the ICI's can be in producing adverse outcomes.


Documented toxicities include (but are not limited to):-


Rash
Pruritis
Vitiligo
Immunobullous skin lesions akin to dermatitis herpetiformis or bullous pemphigoid
Keratinocyte alteration—Grover’s disease [27]/acantholytic dyskeratosis
Immune-reaction mediated by alteration of melanocytes (regression of nevi, prurigo nodularis, tumoural melanosis and vitiligo).
Thyroid dysfunction
Hyperthyroidism
Hypothyroidism
Hypophysitis
Diabetes mellitus
De novo diabetes
Hepatitis
Gastrointestinal toxicity
Diarrhoea
Colitis
Colon perforation
Enterocolitis
Dysphagia
Epigastric pain
Oesophageal ulcerations,
Gastritis,
Duodenitis
Lymphocytic colitis
Pancreatitis
Small bowel enteritis
Pneumonitis
Grade 3 to 4 cough
Grade 3 to 4 dyspnoea
Neurological toxicity
Polyneuropathy
Facial nerve palsy,
Demyelination
Myasthenia gravis,
Guillain Barré syndrome
Posterior reversible leukoencephalopathy
Transverse myelitis
Enteric neuropathy
Encephalitis
Aseptic meningitis
Cardiac toxicity
Myocarditis
Pericarditis
Arrhythmias,
Cardiomyopathy
Impaired ventricular function
Rheumatological toxicity (as you mentioned)
Myalgia
Arthralgia
Vasculitis
Polymyositis,
Myositis
Temporal arteritis
Renal toxicity
Grade 3 to 4 nephritis
Acute kidney injury
Acute tubulo-interstitial nephritis with lymphocytic infiltration
Severe antineutrophil cytoplasmic antibody-associated rapid progressive glomerulonephritis
Ocular toxicities
Peripheral ulcerative keratitis
Uveitis
Vogt–Koyanagi–Harada syndrome
Thyroid-associated orbitopathy and idiopathic orbital inflammation (sceritis, myositis, neuritis, dacryadenitis)
Retinal and choroidal disease (choroidal neovascularisation and melanoma-associated retinopathy)
Haematological toxicities
Lethal aplastic anaemia
Autoimmune haemolytic anaemia
Immune thrombocytopenic purpura


New effects are being discovered all the time.
Such as hyperprogression.


There have been a few isolated reports of actual treatment benefit to a minority.
Though these benefits are normally shortlived.
And I have not been able to verify these reports.


The list of toxicities is not meant to be exhaustive, as new ones are being discovered all the time.
A very versatile treatment..


Strangely, some well-informed patients with advanced disease who wish to extend their survival, opt for best palliative care instead of ICI treatment.

"Management of Toxicities from Immunotherapy: ESMO Clinical Practice Guidelines"

https://www.esmo.org/Guidelines/Supportive-and-Palliative-Care/Management-of-Toxicities-from-Immunotherapy