[Discovery of multi-omics-based biomarkers for immune-related adverse events: precision management with 3D-SPACE]

This article provides a systematic review of the advances in the precise diagnosis and management of immune-related adverse events (irAEs) induced by immune checkpoint inhibitors. IrAEs involve multiple organ systems, exhibit strong clinical heterogeneity, and lack specific biomarkers, all of which significantly compromise treatment safety and patient outcomes. This paper proposes a "3T" strategy centered on "Target, Timing, Tailoring" and constructs an integrated "3D-SPACE" management framework encompassing diagnosis, dynamic risk assessment, directed therapy, surveillance, prevention, adaptive regimen adjustment, collaborative multidisciplinary care, and engaged shared decision-making. Key emphases include the application of multi-omics technologies for early identification and subtyping, artificial intelligence-driven dynamic risk prediction and personalized intervention, as well as novel strategies such as microbial modulation. By establishing a multi-omics-informed, longitudinal management architecture, the framework aims to enable early differentiation between irAEs and severe infections, risk stratification, and precision intervention. Ultimately, it forms a closed-loop management model of "monitoring-warning-prevention-treatment-optimization", offering a systematic solution and practical framework to enhance the safety of immunotherapy.