Cancer immunotherapy research highlights challenges in detecting adverse events

Recent studies published in Nature Cancer and the journal Immunotherapy address the complexities of managing immune-related adverse events (irAEs) caused by immune checkpoint inhibitors (ICIs). These toxicities, which can affect various organ systems, occur in up to 40% of patients receiving such treatments.

A multicentre cohort study of 612 patients found that 244 individuals experienced 354 irAEs. Severe events led to hospitalization or treatment discontinuation in half of those cases, and 16 fatal events were recorded, primarily involving pneumonitis, colitis, or hepatitis. The research noted that chronic toxicities often persist for months after therapy ends.

To improve detection, researchers are exploring the use of agentic artificial intelligence. A study led by Jack Gallifant demonstrated that a large language model-based system could extract details from unstructured clinical notes, such as the severity and attribution of toxicities. While the AI improved the speed and consistency of curation, researchers noted that determining the exact severity of a toxicity remains more difficult for AI than simply recognizing its existence.