ASCO GUIDELINES Bundle

Immune-related Adverse Events from Immune Checkpoint Inhibitor Therapy

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12 Treatment Table A2: Immunosuppressive Agents Immunosuppressive Agents Dosing Indications IVIG (non-selective immunosuppressant) 2 g/kg over 2-5 days in divided doses of 400-500 mg/kg Hematological irAEs, SCAR, pneumonitis, myositis, MG, GBS, encephalitis, demyelinating disease, and uveitis Leflunomide (non-selective immunosuppressant) Loading dose of one 100 mg tablet per day for 3 days Moderate or refractory inflammatory arthritis Methotrexate (MTX) (non-selective immunosuppressant) Starting dose of 15 mg PO weekly, with daily folic acid supplementation Moderate or refractory musculoskeletal and ocular irAEs Mycophenolate mofetil (MMF) (non-selective immunosuppressant) 0.5–1 g orally every 12 hours Steroid-refractory hepatitis, nephritis, pneumonitis, myocarditis, myositis, and hematological irAEs Plasmapheresis (non-selective immunosuppressant) Several courses as needed Myastenia gravis, GBS, demyelinating disease, encephalitis, myositis (cont'd)

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