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Long-Term Toxicities of Immune Checkpoint Inhibitors.

Preethy E Abraham¹, Douglas B Johnson²

¹Vanderbilt University School of Medicine, Nashville, USA.

|October 1, 2025

Summary

This summary is machine-generated.

Immune checkpoint inhibitors (ICIs) can cause chronic autoimmune-like toxicities (irAEs) in up to 50% of patients. This review examines chronic irAEs, focusing on organ-specific impacts and future treatment strategies.

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Area of Science:

Oncology
Immunology
Toxicology

Background:

Immune checkpoint inhibitors (ICIs) offer durable cancer responses but can cause immune-related adverse events (irAEs).
Many irAEs resolve with treatment, but a significant portion persist, leading to chronic conditions.
Chronic irAEs, lasting over 3 months, affect 40-50% of patients, with varied manifestations and severity.

Purpose of the Study:

To review current research on chronic immune-related adverse events (irAEs) following ICI therapy.
To provide an overview of chronic irAEs, including organ-specific considerations.
To discuss challenges and future directions in managing chronic irAEs.

Main Methods:

Literature review of updated studies on chronic irAEs.
Analysis of organ-specific chronic irAE incidence and characteristics.
Discussion of potential therapeutic strategies, such as anti-cytokine therapy.

Main Results:

Endocrine and joint irAEs show high rates of chronicity.
Chronic gastrointestinal, liver, and lung irAEs are less common.
Chronic irAEs may result from persistent inflammation or inflammatory damage sequelae.

Conclusions:

Chronic irAEs represent a significant challenge in ICI therapy, impacting patient quality of life.
Further research is needed to characterize chronic irAEs and develop effective prevention and treatment strategies.
Identifying patients at risk for active inflammation is crucial for personalized management.