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Archive > Volume 32 Issue 8 > 2025,32(8):783-798. DOI:10.3872/j.issn.1007-385X.2025.08.001 Prev Next
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Prediction and diagnosis of immune checkpoint inhibitor-related adverse events
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Abstract:
[Abstract] Immune checkpoint inhibitors (ICIs) based immunotherapy can induce immune-related adverse events (irAEs) while activating T cells and relieving immunosuppression. With the wide application of ICIs in solid tumors, irAEs has become a common clinical issue, seriously affecting the continuous benefits of immunotherapy and quality of life of patients. Therefore, a baseline assessment of patients is required before applying ICIs, such as evaluating the benefits and risks for special groups like those with autoimmune diseases, organ transplants, and viral infections. Meanwhile, the prediction and early identification of irAEs are paramount. Integrating various factors is essential for this purpose, including clinical factors such as underlying diseases and treatment history, host factors like intestinal flora and genetic polymorphisms, and biomarkers including tumor mutational burden, inflammatory indicators, and autoantibodies. In addition, the early symptoms of irAEs, such as fatigue, cough, and elevated bilirubin and transaminase levels, need to be differentiated from infections, tumor progression and adverse events caused by non-ICI interventions. irAE is an exclusion diagnosis and still requires the use of imaging, pathological and multidisciplinary consultation for differentiation. Mechanism research on irAE and prospective clinical trials should be conducted to promote the development precise prediction and treatment of irAE.
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