When utilizing KN-A18 protocol, how do you best address symptoms of colitis/cystitis?

I have now anecdotally heard of 2 patients not completing EBRT/Brachytherapy due to the combined AI colitis picture superimposed on a traditional chemoRT GI toxicity. While there were reasons for patients to not complete pre-ICI, those reasons were generally not because of GI toxicity.

The main thin...

There are overall increased grade 3 toxicities by about 8-10% with the addition of pembro with any immune-related colitis being a small part of it (2-3%). However, the overall treatment time for radiotherapy in the pembrolizumab and placebo arms was 52 days with 85% completing within 56 days.

A great question. We often consult the GI and GU disciplines. Patients are hydrated and electrolyte management is done. Patients are referred to GI and urology. If we feel the GI toxicity is related to pembro then we hold it and start steroids. It can be difficult to tell at times.

I personally hav...