Affiliation:
1. Internal Medicine Study Program, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
2. Department of Internal Medicine, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
3. Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Abstract
The advent of immune checkpoint inhibitors (ICIs) has revolutionized the treatment landscape for various malignancies by harnessing the body’s immune system to target cancer cells. However, their widespread use has unveiled a spectrum of immune-related adverse events, highlighting a critical balance between antitumor immunity and autoimmunity. This review article delves into the molecular immunology of ICIs, mapping the journey from their therapeutic action to the unintended induction of immune-related adverse events. We provide a comprehensive overview of all available ICIs, including cytotoxic T-lymphocyte-associated protein 4, programmed cell death protein 1, programmed death-ligand 1 inhibitors, and emerging targets, discussing their mechanisms of action, clinical applications, and the molecular underpinnings of associated immune-related adverse events. Special attention is given to the activation of autoreactive T cells, B cells, cytokine release, and the inflammatory cascade, which together contribute to the development of immune-related adverse events. Through a molecular lens, we explore the clinical manifestations of immune-related adverse events across organ systems, offering insights into diagnosis, management, and strategies to mitigate these adverse effects. The review underscores the importance of understanding the delicate interplay between enhancing antitumor responses and minimizing immune-related adverse events, aiming to guide future research and the development of next-generation ICIs with improved drug safety profiles.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Reference118 articles.
1. Emerging strategies for cancer immunoprevention.;Roeser;Oncogene,2015
2. Breast cancer immunotherapy: an update.;Makhoul;Breast Cancer (Auckl),2018
3. The dawn of vaccines for cancer prevention.;Finn;Nat Rev Immunol,2017
4. Advances in cancer immunology and cancer immunotherapeutics.;Kumar;IJMIO,2018
5. Delivery of ANTI-PD-1 gene with recombinant adeno-associated virus (RAAV) as preventive and curative therapy of infectious diseases in childhood: literature review.;Afla;Curr Int Med Res Prac Surabaya J,2022