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Updated: Jun 6, 2026
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Monitoring PD-1-Blocking Antibodies Bound to T Cells Derived from a Drop of Peripheral Blood
Published on: February 5, 2020
Immune Checkpoint Inhibitors: efficacy, safety, and biomarkers - a systematic review
Hebatalla Ismail1, Anees Hassan2
1Medical Oncology, St. Vincent's University Hospital, UCD Cancer Centre, Dublin, Ireland.
Frontiers in Oncology
|June 5, 2026
Summary
Immune checkpoint inhibitors (ICIs) like PD-1/PD-L1 and CTLA-4 inhibitors improve cancer survival but cause immune-related adverse events. High tumor mutational burden and PD-L1 expression predict response, but not toxicity.
Area of Science:
- Oncology
- Immunology
- Pharmacology
Background:
- Immune checkpoint inhibitors (ICIs), including PD-1/PD-L1 and CTLA-4 inhibitors, are crucial in cancer therapy.
- These agents enhance progression-free survival (PFS) and overall survival (OS) across various cancers.
- However, ICIs are linked to immune-related adverse events (irAEs) affecting multiple organ systems.
Purpose of the Study:
- To systematically review the safety and efficacy of ICIs.
- To analyze clinical outcomes such as OS, PFS, objective response rate (ORR), and irAEs.
- To evaluate combination strategies involving ICIs.
Main Methods:
- Systematic review of 15 randomized controlled trials and cohort studies.
- Analysis focused on primary clinical outcomes: OS, PFS, ORR, and irAEs.
- Assessment of biomarkers (PD-L1 expression, tumor mutational burden) for predicting response and toxicity.
Main Results:
- ICIs demonstrate durable antitumor activity, particularly in patients with high tumor mutational burden (TMB) and PD-L1 expression.
- Significant toxicities associated with ICIs necessitate immunosuppressive management in some cases.
- Combination therapies (dual blockade, ICI plus chemotherapy) show improved outcomes but increased toxicity compared to monotherapy.
Conclusions:
- While ICIs offer significant survival benefits, managing irAEs remains a challenge.
- PD-L1 expression and TMB are predictive of ICI response but not consistently of irAEs.
- Future research should prioritize refining patient selection, optimizing toxicity management, and discovering novel predictive biomarkers for enhanced ICI therapy benefit-risk ratios.
