Immune Checkpoint Inhibitor Rechallenge After Prior Immune Toxicity

Opinion statement Immune checkpoint inhibitors (ICIs) have become an essential part of treatment for many cancer types. These monoclonal antibodies remove a critical negative regulatory signal that allows the immune system to recognize and destroy malignant cells that were previously undetectable. Unfortunately, their use has ushered in a whole new form of drug toxicity whereby the immune system attacks normal tissues in the body, referred to hereafter as immune-related adverse events (irAEs). irAEs are common and can result in treatment discontinuation, hospitalization, and death. When alternative modes of treatment are limited, or considered less efficacious, there may be a desire to resume treatment with ICIs after an irAE. Rechallenge with ICIs carries with it a heightened risk of subsequent toxicity, but with careful consideration and appropriate patient selection, this can be considered a reasonable approach.

Automated summary

Immune checkpoint inhibitors (ICIs) have become crucial in the treatment of many cancer types, but they also bring about a new form of drug toxicity called immune-related adverse events (irAEs). irAEs are common and can have serious consequences, leading to treatment discontinuation and adverse outcomes for patients. However, with careful consideration and appropriate patient selection, resuming treatment with ICIs can be a reasonable approach.