Hypersensitivity Reactions and Immune-Related Adverse Events to Immune Checkpoint Inhibitors: Approaches, Mechanisms, and Models

Immunol Allergy Clin North Am. 2022 May;42(2):285-305. doi: 10.1016/j.iac.2021.12.006. Epub 2022 Mar 31.

Abstract

Immune checkpoint inhibitors (ICI) are a major class of cancer therapeutics that may cause durable responses in a growing proportion of patients with metastatic cancer. These agents remove negative regulators on T cells and may cause autoimmunelike toxicities that affect all organ systems. Monoclonal antibodies are much less commonly associated with traditional hypersensitivity reactions. Herein, we discuss the pathophysiology, clinical presentation, and management of toxicities of ICI and discuss their broader context within drug hypersensitivity.

Keywords: Allergy; CTLA-4; Colitis; Hypersensitivity; Immune checkpoint inhibitor; PD-1; PD-L1; Toxicity.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal / adverse effects
  • Humans
  • Hypersensitivity* / diagnosis
  • Hypersensitivity* / etiology
  • Hypersensitivity* / therapy
  • Immune Checkpoint Inhibitors / adverse effects
  • Immunotherapy / adverse effects
  • Neoplasms* / drug therapy

Substances

  • Antibodies, Monoclonal
  • Immune Checkpoint Inhibitors