With immune checkpoint inhibitors (ICIs) becoming the mainstay of treatment for many cancers, managing their immune-related adverse events (irAEs) has become an important part of oncological care. This Review covers the clinical presentation of irAEs and crucial aspects of reversibility, fatality and long-term sequelae, with special attention to irAEs in specific patient populations, such as those with autoimmune diseases. In addition, the genetic basis of irAEs, along with cellular and humoral responses to ICI therapy, are discussed. Detrimental effects of empirically used high-dose steroids and second-line immunosuppression, including impaired ICI effectiveness, call for more tailored irAE-treatment strategies. We discuss open therapeutic challenges and propose potential avenues to accelerate personalized management strategies and optimize outcomes.

随着免疫检查点抑制剂（ICIs）成为许多癌症的主要治疗方法，管理其免疫相关不良事件（irAE）已成为肿瘤治疗的重要组成部分。本综述涵盖了 irAE 的临床表现以及可逆性、死亡和长期后遗症的关键方面，特别关注特定患者群体（例如患有自身免疫性疾病的患者）中的 irAE。此外，还讨论了 irAE 的遗传基础以及对 ICI 治疗的细胞和体液反应。经验性使用高剂量类固醇和二线免疫抑制的有害影响，包括 ICI 有效性受损，需要更量身定制的 irAE 治疗策略。我们讨论开放的治疗挑战，并提出加速个性化管理策略和优化结果的潜在途径。