Abstract
The emergence and continuous development of immune checkpoint inhibitors (ICIs) therapy brings a revolution in cancer therapy history, but the major hurdle associated with their usage is the concomitant ICIs-related toxicities that present a challenge for oncologists. The toxicities may involve non-specific symptoms of multiple systems as for the unique mechanism of formation, which are not easily distinguishable from traditional toxicities. A few of these adverse events are self-limiting and readily manageable, but others may limit treatment, cause interruption and need to be treated with methylprednisolone or tumor necrosis factor-α (TNF-α) antibody infliximab, and even directly threaten life. Early accurate recognition and adequate management are critical to the patient's prognosis and overall survival (OS). Several biomarkers such as the expression of programmed cell death ligand 1 (PD-L1), tumor mutation burden (TMB), and microsatellite instability-high (MSI-H)/mismatch repair-deficient (dMMR) have been proved to be the predictors for anti-tumor efficacy of ICIs, but there is a gap in clinical needs for effective biomarkers that predict toxicities and help filter out the patients who may benefit most from these costly therapies while avoiding major risks of toxicities. Here, we summarize several types of risk factors correlated with ICIs-related toxicities to provide a reference for oncologists to predict the occurrence of ICIs-related toxicities resulting in a timely process in clinical practice.
Highlights
The development of immune checkpoint inhibitors (ICIs) has changed the systemic treatments of tumors and rewritten history
It was reported that a low baseline proportion of peripheral blood CD4+ Tregs was associated with subsequent colitis caused by ipilimumab [13], consistent with previous views that Tregs were capable of suppressing autoimmune diseases (ADs)
Ipilimumab The decrease of muscle attenuation (MA) significantly associated with high-grade ipilimumab-related toxicities
Summary
The development of ICIs has changed the systemic treatments of tumors and rewritten history. Even as advanced stage therapy, ICIs have enjoyed unprecedented success in many types of cancers including malignant melanoma [1], non-small cell lung cancer (NSCLC) [2], small cell lung cancer [3], metastatic bladder cancer [4], and urothelial carcinoma [5], etc. Because of such an effective anti-tumor immune response, the Food and Drug Administration (FDA) has approved ICIs for more than thirty indications.
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