Dr Lee Schwartzberg Discusses Side Effects of Checkpoint Inhibitors in Breast Cancer

Lee Schwartzberg, MD, FACP, chief of Division of Hematology Oncology and professor of medicine at the University of Tennessee Health Science Center, discusses side effects seen with PD-1 and PD-L1 inhibitors as well as the recent USPSTF screening recommendations for breast cancer.

Transcript (slightly modified)

Have the side effects of new checkpoint inhibitors in breast cancer been manageable in trials?

Yes, both in breast cancer and in other diseases the side effects are generally manageable. When they’ve been compared head-to-head in other diseases, the side effects of PD-1 and PD-L1 inhibitors are generally less in terms of major side effects compared to chemotherapy. But everyone needs to keep in mind that the toxicity profile is different for checkpoint inhibitors; they get autoimmune types of complications as opposed to hymenologic or cytotoxic complications.

What are your thoughts on the recent USPSTF screening recommendations for breast cancer?

Well, I think the recent recommendations are quite restrictive. I think they are certainly evidence-based, but I think they don’t take into account the totality of benefit from screening. So I think that while it’s reasonable to recommend shared decision making for younger women, I think, in general, when you talk to younger women between the ages of 40 and 50, most all of them want to be screened. I’m not sure there’s a lot of benefit in having that discussion. And I think that there’s actually an absence of data in the older women so my feeling is that lack of evidence shouldn’t be interpreted as proof that it doesn’t work there. We need more information in the older women.