Immune-mediated adverse events associated with the checkpoint inhibitor therapy

Objective: to evaluate immune-related adverse events (irAE) during therapy with immune checkpoint inhibitors. The literary review is based on the analysis of scientific publications hosted on the following databases: CyberLeninka, Web of Science, PubMed, Embase, eLIBRARY, CNKI and MEDLINE. The search was carried out using the following keywords: “immune checkpoints”, “immune-mediated adverse reactions”, “antitumor therapy”, “immune system”, “side effects”, “immune checkpoint inhibitors”. Immune checkpoint inhibitors (ICTs) have become a revolutionary breakthrough in oncology due to their ability to block CTLA-4 and PD-1/PD-L1 signaling pathways, activating lymphocytes and enhancing antitumor immunity. This significantly improved the prognosis of cancer. However, the mechanism of action of ICT, aimed at inhibiting immune checkpoints, can disrupt the regulation of the immune response, leading to the development of irAE. Hormonal drugs, immunosuppressants, and cytokine antagonists are the main agents for the treatment of irAE, but they can suppress antitumor immunity. The issues of mechanisms, biomarkers of early diagnosis and individualized treatment of complications remain unresolved. It is assumed that the wider use of immunotherapy and an in-depth study of the mechanisms of action of immune checkpoint inhibitors, as well as irAE, will solve these problems and optimize the results of treatment of cancer patients. In this regard, this topic is of considerable interest to practicing physicians.