Precision toxicity control in checkpoint immunotherapy.

Abstract

Immune checkpoint inhibitors have changed cancer management. However, immune-related adverse events (irAEs) can disrupt treatment and limit effective combination strategies. The standard of care tends to involve broad immunosuppression, which may compromise antitumor immunity and fail to address the dominant biology of distinct irAEs. Some evidence suggests that irAEs can be mitigated through mechanism-based interventions, including cytokine blockade, tissue-restricted immunomodulation, and strategies targeting pathogenic lymphocytes or humoral pathways. Emerging irAE biomarkers help support personalized risk assessment, diagnosis, and intervention selection. In this review, we examine key advances in targeted interventions and biomarkers and outline a translational and clinical path forward, ranging from clinically useful irAE taxonomies to biomarker-guided trials, to advance precision toxicity control toward clinical practice.