Open Access

Factors associated with immune‑related severe adverse events (Review)

  • Authors:
    • Zhenzhen Su
    • Miaomiao Guan
    • Liyan Zhang
    • Xuemin Lian
  • View Affiliations

  • Published online on: October 31, 2024     https://doi.org/10.3892/mco.2024.2798
  • Article Number: 3
  • Copyright: © Su et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Immune checkpoint inhibitors (ICIs) are frequently used in cancer treatment. Despite their clinical benefits, they can also cause a wide range of immune‑related adverse events (ir‑AEs). The overall incidence of irAEs in cancer patients treated with immunotherapy ranges from 70‑90%, while that of immune‑related severe adverse events (ir‑SAEs) is 10‑43%. ir‑SAEs pose a significant risk to patient safety as they are extremely frequent and lethal. Due to non‑specific manifestations, rapid progression and significant morbidity, it is essential to identify factors associated with ir‑SAEs early to predict high‑risk groups for treatment safety. However, less information is available on the factors causing ir‑SAEs, and further research is needed. The present study reviews the factors associated with ir‑SAEs in terms of demographic characteristics, disease‑related information and laboratory examinations to provide a clinical reference. In terms of demographic characteristics, age, body mass index, smoking, ethnicity and cancer family history may influence the incidence of ir‑SAEs. Regarding disease‑related information, the risks factors associated with ir‑SAEs may include disease history, treatment regimen and cancer type. For laboratory examinations, risk factors associated with ir‑SAEs include the laboratory examination parameters of peripheral blood cells, immunocytes, cytokines/chemokines, genetics, gut microbia, proteins and brain injury markers. All of these risk factors can stimulate the body's inflammatory response, leading to over proliferation of T cells and other inflammatory factors. In addition, the use of ICIs may disrupt gut microbial homeostasis and dysregulate the pre‑existing intestinal ecology, which may therefore trigger inflammatory signaling pathways, affect overall immune function and increase the occurrence of ir‑SAEs. In response to the aforementioned risk factors, it is recommended that medical professionals incorporate their analysis into routine patient testing for early identification of patient ir‑SAEs and to create early individualized interventions to improve the safety for immunotherapy patients.
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January-2025
Volume 22 Issue 1

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Copy and paste a formatted citation
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Spandidos Publications style
Su Z, Guan M, Zhang L and Lian X: Factors associated with immune‑related severe adverse events (Review). Mol Clin Oncol 22: 3, 2025.
APA
Su, Z., Guan, M., Zhang, L., & Lian, X. (2025). Factors associated with immune‑related severe adverse events (Review). Molecular and Clinical Oncology, 22, 3. https://doi.org/10.3892/mco.2024.2798
MLA
Su, Z., Guan, M., Zhang, L., Lian, X."Factors associated with immune‑related severe adverse events (Review)". Molecular and Clinical Oncology 22.1 (2025): 3.
Chicago
Su, Z., Guan, M., Zhang, L., Lian, X."Factors associated with immune‑related severe adverse events (Review)". Molecular and Clinical Oncology 22, no. 1 (2025): 3. https://doi.org/10.3892/mco.2024.2798