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Moving towards personalized treatments of immune-related adverse events
Abstract
The enhancement of immune responses upon treatment with immune checkpoint inhibitors can have the desired outcome of reinvigorating antitumour immune surveillance, but often at the expense of immune-related adverse events (irAEs). This novel disease entity often prompts comparisons with, and extrapolation of treatment approaches from, primary autoimmune disorders. Accordingly, current treatment guidelines for irAEs make generic recommendations adapted from the literature describing primary autoimmune diseases, without taking into consideration the substantial disparity of the immunohistopathological findings within each organ affected by an irAE. The treatment modalities themselves are complex and have many potential drawbacks, such as serious and rarely fatal infections, drug toxicities overlapping with irAEs and the risk of compromising cancer immune surveillance. Herein, we provide an overview of key cellular and soluble immunological factors mediating irAEs and propose a model integrating this knowledge with the immunohistopathological findings of the affected organs for a personalized decision-making process for each patient.
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Metadata
- Authors
- Esfahani, K., Elkrief, A., Calabrese, C., Lapointe, R., Hudson, M., Routy, B., Miller, W. H., & Calabrese, L.
- Affiliations
- McGill University (CA)
- Cleveland Clinic (US)
- Centre Hospitalier de l’Université de Montréal (CA)
- Corresponding author
- Esfahani, Khashayar
- ORCID
- Venue
- Nature Reviews Clinical Oncology
- Published
- 2020-04-03
- Volume
- 17
- Issue
- 8
- Pages
- 504-515
- ISSN
- 1759-4774 (ISSN-L)
- 1759-4782
- OpenAlex
- W3015154527
- Cited by
- 351
- References
- 187
- Citations by year
- 2026: 39 · 2025: 60 · 2024: 65 · 2023: 56 · 2022: 59 · 2021: 51 · 2020: 20
- FWCI
- 4.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nature Reviews Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Keywords
- immune-related adverse events, immune checkpoint inhibitors, personalized treatment, immunohistopathology, immune reconstitution, tumor surveillance, autoimmune disease management, immunopathology
- MeSH terms
- Antineoplastic Agents, Immunological, Humans, Immunologic Factors, Immunologic Surveillance, Immunotherapy, Neoplasms, Drug-Related Side Effects and Adverse Reactions
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