The DOI matches its Crossref record; 103 of the 103 references it cites were found in a registry or an index.
Lessons to be Learnt from Real-World Studies on Immune-Related Adverse Events with Checkpoint Inhibitors: A Clinical Perspective from Pharmacovigilance
Open accessAbstract
The advent of immune checkpoint inhibitors (ICIs) caused a paradigm shift both in drug development and clinical practice; however, by virtue of their mechanism of action, the excessively activated immune system results in a multitude of off-target toxicities, the so-called immune-related adverse events (irAEs), requiring new skills for timely diagnosis and a multidisciplinary approach to successfully manage the patients. In the recent past, a plethora of large-scale pharmacovigilance analyses have characterized various irAEs in terms of spectrum and clinical features in the real world. This review aims to summarize and critically appraise the current landscape of pharmacovigilance studies, thus deriving take-home messages for oncologists. A brief primer to study design, conduction, and data interpretation is also offered. As of February 2020, 30 real-world postmarketing studies have characterized multiple irAEs through international spontaneous reporting systems, namely WHO Vigibase and the US FDA Adverse Event Reporting System. The majority of studies investigated a single irAE and provided new epidemiological evidence about class-specific patterns of irAEs (i.e. anti-cytotoxic T-lymphocyte antigen 4 [CTLA-4] versus anti-programmed cell death 1 [PD-1] receptor, and its ligand [PD-L1]), kinetics of appearance, co-occurrences (overlap) among irAEs, and fatality rate. Oncologists should be aware of both strengths and limitations of these pharmacovigilance analyses, especially in terms of data interpretation. Optimal management (including rechallenge), predictivity of irAEs (as potential biomarkers of effectiveness), and comparative safety of ICIs (also in terms of combination regimens) represent key research priorities for next-generation real-world studies.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Figures

Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“the added value of pharmacovigilance studies has already been demonstrated in various settings (3, 4, 7, 8).”
From The Changing Face of Drug-induced Adrenal Insufficiency in the Food and Drug Administration Adverse Event Reporting System (2022) · cites this paper as [4]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Immune-Related Adverse Events Associated with Immune Checkpoint Blockade
Postow, M. A., Sidlow, R., & Hellmann, M. D. (2018) · New England Journal of Medicine · doi:10.1056/nejmra1703481 · Cited by 4,849
Atezolizumab and nab-paclitaxel in advanced triple-negative breast cancer
Schmid, P., Adams, S., Rugo, H. S., Schneeweiss, A., Barrios, C. H., Iwata, H., Diéras, V., Hegg, R., Im, S.-A., Shaw Wright, G., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1809615 · Cited by 4,350
Brahmer, J. R., Lacchetti, C., Schneider, B. J., Atkins, M. B., Brassil, K. J., Caterino, J. M., Chau, I., Ernstoff, M. S., Gardner, J. M., Ginex, P., et al. (2018) · Journal of Clinical Oncology · doi:10.1200/jco.2017.77.6385 · Cited by 3,713
First-line atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer
Horn, L., Mansfield, A. S., Szczęsna, A., Havel, L., Krzakowski, M., Hochmair, M. J., Huemer, F., Losonczy, G., Johnson, M. L., Nishio, M., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1809064 · Cited by 3,586
Wang, D. Y., Salem, J.-E., Cohen, J. V., Chandra, S., Menzer, C., Ye, F., Zhao, S., Das, S., Beckermann, K. E., Ha, L., et al. (2018) · JAMA Oncology · doi:10.1001/jamaoncol.2018.3923 · Cited by 2,674
Haanen, J. B. A. G., Carbonnel, F., Robert, C., Kerr, K. M., Peters, S., Larkin, J., & Jordan, K. (2017) · Annals of Oncology · doi:10.1093/annonc/mdx225 · Cited by 2,367
Adverse effects of immune-checkpoint inhibitors: epidemiology, management and surveillance
Martins, F., Sofiya, L., Sykiotis, G. P., Lamine, F., Maillard, M., Fraga, M., Shabafrouz, K., Ribi, C., Cairoli, A., Guex-Crosier, Y., et al. (2019) · Nature Reviews Clinical Oncology · doi:10.1038/s41571-019-0218-0 · Cited by 2,314
on behalf of the Society for Immunotherapy of Cancer Toxicity Management Working Group, Puzanov, I., Diab, A., Abdallah, K., Bingham, C. O., Brogdon, C., Dadu, R., Hamad, L., Kim, S., Lacouture, M. E., et al. (2017) · Journal for ImmunoTherapy of Cancer · doi:10.1186/s40425-017-0300-z · Cited by 1,992
Salem, J.-E., Manouchehri, A., Moey, M., Lebrun-Vignes, B., Bastarache, L., Pariente, A., Gobert, A., Spano, J.-P., Balko, J. M., Bonaca, M. P., et al. (2018) · The Lancet Oncology · doi:10.1016/s1470-2045(18)30608-9 · Cited by 1,271
Immune-related adverse events and anti-tumor efficacy of immune checkpoint inhibitors
Das, S., & Johnson, D. B. (2019) · Journal for ImmunoTherapy of Cancer · doi:10.1186/s40425-019-0805-8 · Cited by 1,145
Cited by
Sorted by citations
Schneider, B. J., Naidoo, J., Santomasso, B., Lacchetti, C., Adkins, S., Anadkat, M. J., Atkins, M. B., Brassil, K. J., Caterino, J. M., Chau, I., et al. (2021) · Journal of Clinical Oncology · doi:10.1200/jco.21.01440 · Cited by 2,536
“In general, patients receiving anti–PD-1 or PD-L1 antibodies have a lower incidence of any-grade irAEs than those treated with anti–CTLA-4 agents, with combinations increasing the incidence, severity, and onset of irAEs.(3) Variable onsets have been described for the different toxicities, from early occurrence within…”
BackgroundClinical cancer immunotherapy: Current progress and prospects
Liu, C., Yang, M., Zhang, D., Chen, M., & Zhu, D. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.961805 · Cited by 261
Conducting and interpreting disproportionality analyses derived from spontaneous reporting systems
Cutroneo, P. M., Sartori, D., Tuccori, M., Crisafulli, S., Battini, V., Carnovale, C., Rafaniello, C., Capuano, A., Poluzzi, E., Moretti, U., et al. (2024) · Frontiers in Drug Safety and Regulation · doi:10.3389/fdsfr.2023.1323057 · Cited by 224
Self-citationAdverse Cardiovascular and Pulmonary Events Associated With Chimeric Antigen Receptor T-Cell Therapy
Goldman, A., Maor, E., Bomze, D., Liu, J. E., Herrmann, J., Fein, J. A., Steingart, R. M., Mahmood, S., Schaffer, W. L., Perales, M., et al. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.08.044 · Cited by 159
Chen, C., Wu, B., Zhang, C., & Xu, T. (2021) · International Immunopharmacology · doi:10.1016/j.intimp.2021.107498 · Cited by 136
Metadata
- Authors
- Raschi, E., Gatti, M., Gelsomino, F., Ardizzoni, A., Poluzzi, E., & De Ponti, F.
- Affiliations
- University of Bologna (IT)
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- Corresponding author
- Raschi, Emanuel
- Venue
- Targeted Oncology
- Published
- 2020-07-28
- Volume
- 15
- Issue
- 4
- Pages
- 449-466
- ISSN
- 1776-2596 (ISSN-L)
- 1776-260X
- PMC
- PMC7434791
- OpenAlex
- W3046013618
- Cited by
- 157
- References
- 103
- Citations by year
- 2026: 16 · 2025: 21 · 2024: 35 · 2023: 22 · 2022: 29 · 2021: 30 · 2020: 3
- FWCI
- 2.25
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Targeted Oncology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Pharmacology (medical) › Drug-Induced Adverse Reactions
- Keywords
- immune-related adverse events, immune checkpoint inhibitors, pharmacovigilance, real-world evidence, spontaneous adverse event reporting, CTLA-4 inhibitors, PD-1/PD-L1 inhibitors, irAE management, drug rechallenge, treatment response biomarkers
- MeSH terms
- Immune Checkpoint Inhibitors, Humans, Pharmacovigilance
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review