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{
    "pk": 13369,
    "title": "Oncologic Emergencies: Immune-Based Cancer  Therapies and Complications",
    "subtitle": null,
    "abstract": "Cancer therapies have undergone several recent advancements. Current cancer treatments include immune-based therapies comprised of checkpoint inhibitors, and adoptive immunotherapy; each treatment has the potential for complications that differ from chemotherapy and radiation. This review evaluates immune-based therapies and their complications for emergency clinicians. Therapy complications include immune-related adverse events (irAE), cytokine release syndrome (CRS), autoimmune toxicity, and chimeric antigen receptor (CAR) T-cell-related encephalopathy syndrome (CRES). Immune-related adverse events are most commonly encountered with checkpoint inhibitors and include dermatologic complications, pneumonitis, colitis/diarrhea, hepatitis, and endocrinopathies. Less common irAEs include nephritis, myocardial injury, neurologic toxicity, ocular diseases, and musculoskeletal complications. CRS and CRES are more commonly associated with CAR T-cell therapy. CRS commonly presents with flu-like illness and symptoms resembling sepsis, but severe myocardial and pulmonary disease may occur. Critically ill patients require resuscitation, broad-spectrum antibiotics, and hematology/oncology consultation.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Cancer"
        },
        {
            "word": "malignancy"
        },
        {
            "word": "immune-based"
        },
        {
            "word": "therapy"
        },
        {
            "word": "adverse effects"
        },
        {
            "word": "Immunotherapy"
        },
        {
            "word": "checkpoint inhibitor"
        },
        {
            "word": "CAR T"
        }
    ],
    "section": "Clinical Practice",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/8hm46787",
    "frozenauthors": [
        {
            "first_name": "Brit",
            "middle_name": "Jeffrey",
            "last_name": "Long",
            "name_suffix": "",
            "institution": "Brooke Army Medical Center, Department of Emergency Medicine, Fort Sam Houston, Texas",
            "department": "None"
        },
        {
            "first_name": "Elizabeth",
            "middle_name": "",
            "last_name": "Brém",
            "name_suffix": "",
            "institution": "University of California, Irvine Health, Division of Hematology/Oncology, Orange, California",
            "department": "None"
        },
        {
            "first_name": "Alex",
            "middle_name": "",
            "last_name": "Koyfman",
            "name_suffix": "",
            "institution": "The University of Texas Southwestern Medical Center, Department of Emergency Medicine, Dallas, Texas",
            "department": "None"
        }
    ],
    "date_submitted": "2019-11-16T02:44:10Z",
    "date_accepted": "2019-11-16T02:44:10Z",
    "date_published": "2020-04-13T22:29:26Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/13369/galley/7018/download/"
        }
    ]
}