Multisystem immune-related adverse reactions with immune checkpoint inhibitors

Immune checkpoint inhibitors have transformed oncologic practice, producing durable responses in many patients with advanced malignancies. However, these treatments can cause immune-related adverse reactions. This article describes a patient with metastatic non-small cell lung cancer who developed toxicities involving multiple organ systems shortly after receiving combined ipilimumab and nivolumab. Although toxicity is more common in just one organ system, multisystem adverse reactions are possible, and clinicians who recognize and manage these reactions promptly can improve patient outcomes.