Current status of management of immune-related adverse events and practical needs for oncologist education.

Abstract

Immune checkpoint inhibitors have markedly improved outcomes in patients with multiple advanced malignancies. However, their widespread use has markedly increased the incidence of immune-related adverse events (irAEs). irAEs can affect a wide range of organ systems and are characterized by heterogeneous onset, broad toxicity spectra, and complex management requirements, thus ultimately impairing treatment continuation and patient quality of life. This review systematically summarizes the epidemiological features, clinical progression, and current management of irAEs. Existing guidelines largely focus on acute toxicities but have not provided structured strategies for chronic, delayed-onset, or multisystem irAEs. Moreover, clinical practice is hampered by incomplete multidisciplinary collaboration, insufficient training of oncologists, and fragmented treatment pathways, all of which limit the efficacy of irAE management. We propose incorporating irAE management into core oncology training and call for the establishment of comprehensive interdisciplinary frameworks to ensure the standardized long-term use of immunotherapy.