The biomarkers related to immune related adverse events caused by immune checkpoint inhibitors
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(2020) 39:284
REVIEW
Open Access
The biomarkers related to immune related adverse events caused by immune checkpoint inhibitors Xiao-Hui Jia1, Lu-Ying Geng1, Pan-Pan Jiang1, Hong Xu1, Ke-Jun Nan1,2, Yu Yao1, Li-Li Jiang1, Hong Sun1, Tian-Jie Qin1 and Hui Guo1,3,4*
Abstract The enthusiasm for immune checkpoint inhibitors (ICIs), an efficient tumor treatment model different from traditional treatment, is based on their unprecedented antitumor effect, but the occurrence of immune-related adverse events (irAEs) is an obstacle to the prospect of ICI treatment. IrAEs are a discrete toxicity caused by the nonspecific activation of the immune system and can affect almost all tissues and organs. Currently, research on biomarkers mainly focuses on the gastrointestinal tract, endocrine system, skin and lung. Several potential hypotheses concentrate on the overactivation of the immune system, excessive release of inflammatory cytokines, elevated levels of pre-existing autoantibodies, and presence of common antigens between tumors and normal tissues. This review lists the current biomarkers that might predict irAEs and their possible mechanisms for both nonspecific and organ-specific biomarkers. However, the prediction of irAEs remains a major clinical challenge to screen and identify patients who are susceptible to irAEs and likely to benefit from ICIs.
Background In recent years, immune checkpoint inhibitors (ICIs) have achieved gratifying effects in a wide variety of tumors, including melanoma [1], renal cell carcinoma [2] and non-small cell lung cancer (NSCLC) [3], which greatly changed the traditional tumor treatment strategy and brought more survival benefits to patients [4, 5]. However, much of the enthusiasm for ICIs is based on long-term survival benefits, which occur in only a few patients. The survival benefit of patients is not only determined by the efficacy but also affected by adverse events. While ICIs represent a new field against cancer, they have also produced a unique set of immune-related adverse events (irAEs) that could have serious or even * Correspondence: [email protected] 1 Department of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China 3 Key Laboratory of Environment and Genes Related to Diseases, Xi’an Jiaotong University, Ministry of Education of China, Xi’an, Shaanxi, China Full list of author information is available at the end of the article
fatal consequences. Only by improving efficacy and reducing toxicity as much as possible could patient survival be improved. Undeniably, irAEs are very common, depending on the ICI mechanism. The application of ICIs destroys the mechanism that might protect tissues from autoimmune response damage [6], enhances the activity of T cells against antigens presented in tumors and healthy tissues [7], and increases the level of preexisting autoantibodies and inflammatory factors [7], leading to a series of irAEs. However, current research on the mechanisms of irAEs is still in the early stage, and there ar
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