[Immunotherapy-Induced Adverse Events: A Focus of Intensive Care Medicine]

Immunotherapies, including checkpoint inhibitors and T-cell-activating therapies (CAR-T cells, BiTE), have transformed oncology but carry risks of severe toxicities. Checkpoint inhibitors may induce immune-related adverse events (irAEs) such as pneumonitis, myocarditis, or neurological syndromes, often requiring intensive care. T-cell therapies frequently cause acute cytokine release syndrome (CRS) and neurotoxicity (ICANS), while late toxicities like hemophagocytic syndrome (IEC-HS) and delayed neurotoxicity (TIAN, Guillain-Barré) are gaining relevance. Management includes grade-adapted immunosuppression, steroids, IL-6/IL-1 inhibitors, and interdisciplinary intensive care. Despite established algorithms, prognosis remains critical in multiorgan involvement or other high-grade toxicities. Early diagnosis and individualized risk-benefit assessment are crucial for treatment success.