Immune checkpoint inhibitor-associated toxicity in advanced non-small cell lung cancer: An updated understanding of...

Area of Science:

• Oncology
• Immunology

Background:

• Immune checkpoint inhibitors (ICIs) like PD-1, PD-L1, and CTLA-4 antibodies have transformed cancer therapy, particularly for non-small cell lung cancer (NSCLC).
• Despite clinical benefits in some NSCLC patients, ICIs are associated with a spectrum of immune-related adverse events (irAEs) affecting multiple organ systems.
• Understanding and predicting irAEs is crucial for safe and effective immunotherapy in NSCLC.

Purpose of the Study:

• To provide a comprehensive review of updated clinical manifestations, underlying mechanisms, predictive biomarkers, and management strategies for ICI-associated toxicities in NSCLC.
• To highlight current knowledge gaps and suggest future research directions for NSCLC-related irAEs.

Main Methods:

• Systematic literature review of clinical studies and preclinical research on ICI-associated irAEs in NSCLC.
• Analysis of reported irAEs, their clinical presentations, etiological mechanisms, and potential predictive biomarkers.
• Evaluation of current management guidelines and therapeutic approaches for irAEs.

Main Results:

• ICIs can induce diverse irAEs impacting cardiac, pulmonary, gastrointestinal, endocrine, and dermatologic systems, with varying severity.
• Several biomarkers are under investigation for predicting irAE susceptibility, though none are definitively established.
• Effective management strategies involve early recognition, prompt intervention, and often, immunosuppressive therapy.

Conclusions:

• ICI therapy offers significant advantages in NSCLC treatment but necessitates careful monitoring for irAEs.
• Further research into robust predictive biomarkers and refined management protocols is essential to optimize immunotherapy outcomes in NSCLC patients.
• A multidisciplinary approach is key to managing the complex landscape of ICI-induced toxicities.