# Immune-Related Adverse Events in Anti–PD-1 Therapy

## What immune-related adverse events are associated with anti–PD-1 therapy and how are they managed?

Anti-PD-1 therapy is associated with immune-related adverse events affecting the endocrine, gastrointestinal, dermatologic, pulmonary, and hepatic systems in 38-69% of patients, managed primarily with corticosteroids at 1-2 mg/kg/day that resolve approximately 80% of cases within 5 weeks, with treatment holds or discontinuation for higher-grade toxicities.

## Abstract

Anti-PD-1 therapy is associated with immune-related adverse events (irAEs) affecting 38-69% of patients, involving primarily the endocrine, gastrointestinal, dermatologic, pulmonary, and hepatic systems. Common irAEs include thyroiditis (4-34%), colitis (2.8-22%), rash (1-18%), pneumonitis (3-13%), and hepatotoxicity (0.8-11%). Most irAEs are mild to moderate (grade 1-2), with grade 3-4 events occurring in approximately 7-20% of patients. While most irAEs develop within 12-14 weeks of treatment initiation, delayed onset beyond 12 months occurs in 5.3% of patients, and chronic irAEs persisting beyond 12 weeks after treatment cessation develop in 43.2% of patients, with 85.6% persisting at last follow-up. Endocrinopathies (83%), neurotoxicities (73%), and arthritis (49%) are particularly likely to become chronic, while visceral organ toxicities show lower chronicity rates.

Corticosteroids at 1-2 mg/kg/day represent the cornerstone of irAE management, with approximately 80% of irAEs resolving within a median of 5 weeks with immunosuppressive therapy. Steroid-refractory cases may require additional agents such as infliximab, which can provide symptom relief within 24 hours for gastrointestinal irAEs. Treatment modifications include temporary holds for grade 2 toxicity and permanent discontinuation for grades 3-4, required in 14-15% of patients. Critically, immunosuppressive treatment does not impair anti-tumor efficacy, and tumor progression is less frequent in patients experiencing irAEs. Successful management depends on early recognition and prompt corticosteroid initiation, multidisciplinary collaboration, and systematic monitoring protocols. Patients with preexisting autoimmune disease experience higher rates of disease flares (52%), with severity correlating to baseline immunosuppression intensity.

## Methods

We analyzed 10 sources from an initial pool of 200, using 8 screening criteria. Each paper was reviewed for 6 key aspects that mattered most to the research question.

### Records from Elicit search

- n = 200

### Papers screened using:
- PD-1 Therapy Population
- Approved PD-1 Inhibitors
- Immune-Related Adverse Events Reporting
- Management Strategies
- Study Design
- PD-1 Specificity
- PD-1 Attribution
- Publication Type

- n = 200 Papers screened out
- n = 190 Papers included for extraction

## Paper search

We performed a semantic search across over 138 million academic papers from the Elicit search engine, which includes all of Semantic Scholar and OpenAlex.

We ran this query: “What immune-related adverse events are associated with anti–PD-1 therapy and how are they managed?”

The search returned 200 total results from Elicit. We retrieved 200 papers most relevant to the query for screening.

## Screening

We screened in sources based on their abstracts that met the following criteria:

- **PD-1 Therapy Population**: Does this study include patients receiving anti-PD-1 therapy for any malignancy?
- **Approved PD-1 Inhibitors**: Does this study investigate pembrolizumab, nivolumab, cemiplimab, dostarlimab, or other FDA/EMA-approved PD-1 inhibitors?
- **Immune-Related Adverse Events Reporting**: Does this study report immune-related adverse events as primary or secondary outcomes?
- **Management Strategies**: Does this study describe management strategies, treatment protocols, or interventions for immune-related adverse events?
- **Study Design**: Is this study a randomized controlled trial, cohort study, case-control study, case series with ≥10 patients, systematic review, or meta-analysis?
- **PD-1 Specificity**: Does this study focus on PD-1 inhibitors rather than exclusively on PD-L1 inhibitors, CTLA-4 inhibitors, or other non-PD-1 checkpoint inhibitors?
- **PD-1 Attribution**: If this study involves combination therapies, can the immune-related adverse events be attributed specifically to the PD-1 component, OR does the study focus on PD-1 monotherapy?
- **Publication Type**: Is this study something other than a case report, editorial, letter, conference abstract, or opinion piece?

We considered all screening questions together and made a holistic judgement about whether to screen in each paper.

## Data extraction

We asked a large language model to extract each data column below from each paper. We gave the model the extraction instructions shown below for each column.

### Study Design
- Study type (retrospective/prospective, case series, clinical trial, etc.)
- Sample size of patients receiving anti-PD-1 therapy
- Follow-up duration for irAE monitoring
- irAE grading system used (CTCAE version, etc.)
- Single vs. multi-center

### Patient Population
- Cancer type(s) and stage
- Treatment line (first-line, second-line, etc.)
- Age and relevant demographics
- Performance status (ECOG, KPS)
- Preexisting autoimmune conditions or immunosuppression
- Prior cancer treatments that might affect irAE risk

### Anti-PD-1 Treatment
- Specific agent(s) (nivolumab, pembrolizumab, cemiplimab, etc.)
- Dosing regimen and schedule
- Treatment duration before irAE occurrence
- Combination with other checkpoint inhibitors (anti-CTLA-4)
- Concomitant medications that might affect irAE risk

### irAE Types
- Specific organ systems affected (endocrine, gastrointestinal, dermatologic, pulmonary, hepatic, neurologic, musculoskeletal, cardiac, ocular, etc.)
- Exact irAE diagnoses (thyroiditis, colitis, pneumonitis, myocarditis, etc.)
- Severity grade (CTCAE 1-5 or equivalent)
- Time to onset from treatment initiation
- Incidence rates or frequencies
- Duration of irAEs

### irAE Management
- Anti-PD-1 therapy modifications (dose reduction, temporary hold, permanent discontinuation)
- Immunosuppressive treatments (corticosteroids, dose and duration; other agents like infliximab, mycophenolate)
- Supportive care measures and symptom management
- Hospitalization requirements and duration
- Specialist consultations required
- Monitoring protocols during treatment
- Criteria for treatment resumption

### Management Outcomes
- Resolution rates and time to resolution
- Effectiveness of different management approaches
- irAE recurrence after treatment resumption
- Long-term sequelae or permanent effects
- Treatment-related mortality from irAEs
- Impact on cancer treatment continuation and efficacy
- Patient quality of life effects
- Factors associated with successful vs. unsuccessful management

## Results

### Characteristics of Included Studies

The review included 10 sources examining immune-related adverse events associated with anti-PD-1 therapy. Study designs varied from retrospective case series to reviews of clinical trial data, with sample sizes ranging from 27 to 999 patients.

| Study | Full text retrieved? | Study Type | Sample Size | Cancer Type(s) | Follow-up Duration | irAE Grading System |
| --- | --- | --- | --- | --- | --- | --- |
| T. Eigentler et al., 2016 | No | Retrospective analysis of pooled trial data | Not specified | Multiple malignancies | Not specified | Not specified |
| J. Weber et al., 2016 | Yes | Review article | Not specified | Advanced melanoma, NSCLC, renal cell carcinoma | Most grade 3/4 irAEs occur within 12-14 weeks | CTCAE v4.03 |
| G. O’Kane et al., 2017 | Yes | Review of phase III trials | Data from multiple trials | Metastatic NSCLC | Every 12 weeks up to 1 year post-discontinuation | CTCAE v4.0 |
| J. Patrinely et al., 2021 | No | Retrospective multicenter cohort | 387 | Stage III-IV melanoma | Beyond 12 weeks post-discontinuation | Not specified |
| L. Hofmann et al., 2016 | No | Case series | 496 | Metastatic melanoma | Not specified | Not specified |
| D. Iacono et al., 2020 | No | Retrospective single-center | 130 (82% received anti-PD-1) | NSCLC (49%), melanoma (42%), kidney (7%), other (2%) | Jan 2012-Dec 2017 | CTCAE v4.0 |
| C. Owen et al., 2021 | Yes | Retrospective multicenter | 999 | Melanoma | Median 21 months | Severity grades used but version not specified |
| S. Vardhana et al., 2018 | Yes | Review article | Aggregated from multiple trials | Classical Hodgkin lymphoma | Varies by trial | Not specified (grade 3 mentioned) |
| L. Zimmer et al., 2016 | No | Case series | 496 | Metastatic melanoma | Not specified | Not specified |
| S. Hoa et al., 2021 | No | Retrospective multicenter | 27 | Lung cancer and melanoma | Median 11.0 months (IQR 6.0-17.5) | Not specified |

Most studies focused on melanoma or lung cancer populations. Treatment lines varied, with Iacono et al. reporting 27% first-line, 57% second-line, and 16% third-line or beyond. Vardhana et al. noted patients with classical Hodgkin lymphoma typically received anti-PD-1 as third-line or later therapy. Performance status was generally good, with 96% having ECOG PS ≤1 in the Iacono cohort, and ECOG 0-1 in the Hodgkin lymphoma population.

### Anti-PD-1 Agents and Treatment Regimens

The primary anti-PD-1 agents examined were nivolumab and pembrolizumab. Dosing regimens included nivolumab 3 mg/kg IV every 2 weeks and pembrolizumab at 2 mg/kg or 10 mg/kg every 3 weeks. In the Iacono cohort, nivolumab was used in 60% of patients, pembrolizumab in 21%, and atezolizumab in 1%.

Combination therapy with anti-CTLA-4 inhibition (ipilimumab) was examined in several studies. Owen et al. reported 20 patients who experienced delayed irAEs after initial combination with anti-CTLA-4. In the Hoa cohort of patients with preexisting autoimmune disease, 2 patients received sequential anti-CTLA-4 therapy.

### Incidence and Spectrum of Immune-Related Adverse Events

#### Overall Incidence

The incidence of any irAE varied across studies. Patrinely et al. reported that 69.0% of patients experienced acute irAEs during treatment, with 19.5% developing grades 3-5 events. Iacono et al. found that 38% of patients developed irAEs. In patients with preexisting autoimmune disease, Hoa et al. observed PAD exacerbations in 52% of cases.

Eigentler et al. noted that the severity of adverse events of specific interest (AEOSI) was generally mild to moderate (grade 1-2), with grade 3-4 events occurring in ≤2% for any individual event term.

#### Organ System Involvement and Specific irAEs

| Organ System | Specific irAEs | Incidence | Severity | Time to Onset | Source |
| --- | --- | --- | --- | --- | --- |
| Endocrine | Thyroiditis, hypothyroidism | 4-7%; most common (34%); 9-16% hypothyroidism | Typically grade 1-2 | 9-12 weeks | O’Kane et al., Weber et al., Iacono et al., Vardhana et al. |
| Endocrine | Hypophysitis | Not specified | Grade 1-2 | 9-12 weeks | Weber et al. |
| Endocrine | Diabetes mellitus | Rare | Not specified | Not specified | Hofmann et al. |
| Gastrointestinal | Colitis, diarrhea | 14%; 2.8-2.9% high-grade; 2-3%; 22% delayed | Grade 3-4 common | ~7 weeks; 3.5-5.3 months | Weber et al., Iacono et al., Vardhana et al., Owen et al. |
| Gastrointestinal | Enteritis, gastritis, esophagitis | Not specified | Not specified | ~7 weeks | Weber et al. |
| Dermatologic | Rash, cutaneous toxicity | 18%; 1-9%; 18% delayed | Variable | ~2 weeks | Weber et al., Iacono et al., Vardhana et al., Owen et al. |
| Dermatologic | Lichen planus | Rare | Not specified | Not specified | Hofmann et al. |
| Pulmonary | Pneumonitis | 3%; 13% delayed | High-grade | 15.1-31.1 weeks median; 3.3-3.5 months | Weber et al., O’Kane et al., Vardhana et al., Owen et al. |
| Hepatic | Hepatotoxicity, hepatitis | 2.3% nivolumab, 0.8% pembrolizumab; up to 11%; 0.7-1.8% autoimmune hepatitis | High-grade | 9-12 weeks; 1-3 months | Weber et al., O’Kane et al., Vardhana et al. |
| Neurologic | Encephalitis, myasthenia-like syndrome | Not specified | Variable | Not specified | O’Kane et al. |

The timing of irAE onset showed considerable variation. Eigentler et al. noted medians ranging from 1 to 6 months, with most events being unpredictable in timing. Skin irAEs typically appeared earliest at approximately 2 weeks, followed by gastrointestinal events at 7 weeks, and endocrine and hepatic events at 9-12 weeks.

#### Chronic and Delayed irAEs

Patrinely et al. provided detailed characterization of chronic irAEs, defined as those persisting at least 12 weeks after therapy cessation. They found that 43.2% of patients developed chronic irAEs, with most being mild (96.4% grade 1-2) and persisting until last follow-up in 85.6% of cases. Certain organ systems were particularly prone to chronicity: endocrinopathies in 83.0% of cases, neurotoxicities in 73.3%, ocular events in 62.5%, xerostomia in 52.9%, and arthritis in 48.9%. In contrast, visceral organ irAEs showed lower chronicity rates, with colitis becoming chronic in only 13.6% of cases, of which 66.7% eventually resolved.

Owen et al. examined delayed irAEs occurring more than 12 months after treatment initiation, with an estimated incidence of 5.3%. The median onset was 16 months (range 12-53). Delayed irAEs were often high-grade, with 39% being grade 3 or higher. The most common delayed irAEs were colitis (22%), rash (18%), and pneumonitis (13%). Among patients developing delayed irAEs, 74% were still on anti-PD-1 at onset, 12% were less than 3 months from last dose, and 14% were more than 3 months from last dose. Early irAEs had occurred in 58% of patients who later developed delayed irAEs, affecting a different organ system in 86% of these cases.

#### Special Populations

In patients with preexisting autoimmune disease, Hoa et al. found that 52% experienced PAD exacerbations, with 14% being severe. These flares required corticosteroids in 57% of cases, immunosuppression in 50%, and ICI discontinuation in 14%. Exacerbations occurred despite background immunosuppression at ICI initiation and were more frequent and severe in patients who previously required more intensive immunosuppression such as biologics. In patients with preexisting psoriasis, inflammatory bowel disease, and axial spondyloarthritis, rheumatic irAEs including polyarthritis and tenosynovitis were frequently observed.

## Management of Immune-Related Adverse Events

### Treatment Modifications

Anti-PD-1 therapy management varied by irAE severity. O’Kane et al. recommended holding treatment for grade 2 symptoms and permanent discontinuation for grades 3-4. Weber et al. noted that symptoms must improve to baseline or grade 1 toxicity before resuming treatment. Vardhana et al. advised delaying or stopping therapy depending on IMAE severity. Across studies, 14-15% of patients required permanent ICI discontinuation due to irAEs.

Eigentler et al. indicated that therapy restart was a principal option after recovery from grade 2 AEOSI or diminution of higher-grade skin or endocrine events to mild severity.

### Immunosuppressive Therapy

Corticosteroids were the primary immunosuppressive treatment across all studies. Weber et al. recommended oral prednisone at 1-2 mg/kg/day for moderate symptoms, with IV methylprednisolone for severe cases requiring hospitalization. O’Kane et al. specified 0.5-1 mg/kg/day corticosteroids for grade 2 symptoms, 1-2 mg/kg/day for grade 3, and IV corticosteroids for grade 4. Eigentler et al. noted that methylprednisolone or equivalent glucocorticoids managed most AEOSI effectively.

Owen et al. reported that steroids were required in 68% of patients with delayed irAEs. In the Iacono cohort, 48% of patients with irAEs required immunosuppressive treatment. The median time to resolution varied by irAE type; Owen et al. found a median of 5 months for most delayed irAEs, with rheumatological irAEs requiring a median of 15 months of corticosteroid treatment.

For steroid-refractory cases, additional immunosuppressive agents were employed. Weber et al. recommended infliximab for refractory gastrointestinal irAEs, except in cases of perforation or sepsis. Owen et al. found that 23% of patients with delayed irAEs required additional immunosuppressive agents beyond steroids. Iacono et al. reported one patient receiving infliximab as second-line treatment after steroid failure. Eigentler et al. noted that non-steroidal immunosuppressants could be used for refractory or recalcitrant, long-lasting immune toxicities.

Vardhana et al. described steroid-sparing immunosuppressants for refractory pneumonitis, while also providing supportive care measures including thyroid hormone replacement for hypothyroidism and beta-blockers for hyperthyroidism.

Weber et al. emphasized that immunosuppression should be brief (2 weeks to 2 months) to avoid opportunistic infections, and that prolonged steroid tapers were important for successful management.

### Healthcare Utilization

The management of irAEs required substantial healthcare resources. Iacono et al. documented 373 unscheduled accesses to healthcare facilities, with 24% (89 accesses) due to irAEs; 78 were unplanned oncology consultations and 11 were emergency department visits. IrAEs led to hospitalization in 14 patients for a cumulative 118 days, with colitis requiring the longest hospitalization (range 4-31 days). The management required 67 specialist consultancies and additional diagnostic examinations.

O’Kane et al. recommended hospitalization for grade 3 or higher irAEs, with intensive care consideration for grade 4 events. Vardhana et al. advised a low threshold for hospitalization in cases of hypoxia or respiratory distress. Owen et al. found that 45% of patients with delayed colitis required hospital admission.

### Supportive Care and Monitoring

Beyond immunosuppression, supportive care measures included hydration and loperamide for diarrhea, gastroprotection with proton pump inhibitors or histamine blockers. O’Kane et al. recommended surveillance every 12 weeks up to 1 year after immunotherapy discontinuation.

Specialist consultations were frequently necessary. O’Kane et al. recommended pulmonary and infectious disease consultations for pneumonitis and neurologist involvement for neurological irAEs. Vardhana et al. similarly advised consultation with pulmonary and infectious diseases physicians for severe pneumonitis. Iacono et al. emphasized that a multidisciplinary approach and trained hospital network were crucial for efficient management.

Eigentler et al. stressed that early diagnosis and close clinical monitoring were essential for successful management. Vardhana et al. highlighted the importance of early recognition, prompt corticosteroid therapy, and awareness of common IMAEs as factors associated with successful management.

## Treatment Outcomes

### Resolution and Recovery

Resolution rates varied by irAE type and management approach. Weber et al. reported that approximately 80% of irAEs resolved within a median of 5 weeks with immune-modulating medication, except for endocrinopathies which often persisted. Infliximab demonstrated particular effectiveness for gastrointestinal irAEs, with symptom alleviation possible within 24 hours.

For specific irAEs, Vardhana et al. found that pneumonitis resolved completely in approximately 60% of affected patients and colitis resolved completely in ≥74% of affected patients. O’Kane et al. reported median pneumonitis resolution times of 5.0-5.7 weeks.

Owen et al. found that 57% of delayed irAEs eventually resolved, while 43% remained ongoing at last follow-up. The median time to resolution was 5 months, though rheumatological irAEs led to chronic morbidity.

Eigentler et al. noted that the majority of events were reversible, with no impact of time of onset on reversibility. However, Patrinely et al. found that most chronic irAEs (85.6%) persisted until last available follow-up.

### Mortality

Fatal irAEs were uncommon but documented. Patrinely et al. reported one patient each with fatal myocarditis and neurotoxicity. Owen et al. documented two irAE-related deaths: one from encephalitis occurring during anti-PD-1 therapy and one from multiple organ irAEs with onset 11 months after cessation. O’Kane et al. noted that deaths from pneumonitis had been reported.

### Impact on Cancer Treatment

The relationship between irAE management and cancer outcomes appeared favorable. O’Kane et al. reported that steroid treatment did not affect PD-1 inhibitor efficacy. Owen et al. found minimal impact on cancer outcomes from delayed irAEs or immunosuppressive therapy. Hoa et al. observed that tumor progression was not associated with immunosuppressive drug exposure before or after ICI initiation and was numerically less frequent in patients with irAEs.

Vardhana et al. emphasized that prompt management allowed for resumption of therapy and maintenance of disease control, highlighting that corticosteroid therapy was effective in reducing toxicity while allowing continuation of PD-1 inhibitor therapy.

### Factors Associated with Management Success

Several factors emerged as important for successful irAE management. Eigentler et al. identified early diagnosis and close clinical monitoring as essential. Weber et al. highlighted good communication, early recognition of high-grade irAEs, and prolonged steroid tapers as critical factors. Vardhana et al. similarly emphasized early recognition, prompt corticosteroid therapy, and awareness of common IMAEs.

Patrinely et al. found that age, gender, time of onset, and need for steroids were not associated with the likelihood of irAE chronicity. However, Hoa et al. observed that flares in patients with preexisting autoimmune disease were more frequent and severe in those who previously required more intensive immunosuppression.

Iacono et al. emphasized that a multidisciplinary approach and a trained hospital network played a key role in efficient diagnostic and treatment work-up.

## Synthesis

The evidence reveals several important patterns regarding immune-related adverse events with anti-PD-1 therapy. While overall incidence rates of any irAE ranged from 38-69% across studies, the variation appears largely explained by differences in irAE definitions, follow-up duration, and population characteristics. Studies with longer follow-up naturally captured more events, particularly delayed and chronic irAEs.

The spectrum of irAEs showed consistency across cancer types, with endocrine, gastrointestinal, dermatologic, and pulmonary systems most frequently affected. However, certain populations demonstrated distinct patterns. The Hodgkin lymphoma population studied by Vardhana et al. showed particular vulnerability to pneumonitis (3%), likely related to prior bleomycin and radiation exposure. Patients with preexisting autoimmune disease experienced high rates of disease flares (52%), with severity correlating to pre-treatment immunosuppression intensity, suggesting that baseline immune dysregulation predicts irAE severity.

The temporal patterns of irAEs revealed important clinical implications. While most irAEs occurred within the first 12-14 weeks of treatment, delayed irAEs beyond 12 months affected 5.3% of patients, with 74% occurring while still on treatment. This challenges the assumption that irAE risk diminishes with treatment duration and supports continued vigilance throughout therapy.

Chronicity emerged as a critical but under-recognized dimension. Patrinely et al.’s finding that 43.2% of patients developed chronic irAEs contrasts with earlier perceptions of irAEs as largely reversible. However, this apparent discrepancy resolves when examining organ-specific patterns. Endocrinopathies showed 83% chronicity but remained manageable with hormone replacement. In contrast, visceral organ toxicities like colitis had lower chronicity rates (13.6%) but required more intensive acute management, with 45% needing hospitalization and prolonged corticosteroid courses. Both patterns may be correct: endocrine irAEs persist but cause minimal morbidity with appropriate replacement, while gastrointestinal irAEs typically resolve but demand aggressive initial management.

Management strategies showed remarkable consistency despite heterogeneous study populations. Corticosteroids at 1-2 mg/kg/day formed the cornerstone of therapy across all severity grades and organ systems, with 68% of delayed irAE cases requiring steroids and 48% of general cases needing immunosuppression. Resolution rates of 60-80% with standard management support this approach. The effectiveness of this uniform strategy across diverse irAE types suggests a common immunologic mechanism despite varied clinical presentations.

The critical question of whether immunosuppression impairs cancer control showed consistent reassurance across studies. Neither steroid treatment nor additional immunosuppression affected anti-PD-1 efficacy, and tumor progression was actually less frequent in patients experiencing irAEs. This pattern aligns with the hypothesis that irAEs reflect immune activation that also mediates anti-tumor effects. The finding that prompt immunosuppression allows treatment resumption and maintenance of disease control suggests the optimal approach is aggressive early management rather than treatment delays.

Resource utilization data from Iacono et al., showing 89 unscheduled healthcare accesses and 67 specialist consultations for irAEs in 130 patients, demonstrates the substantial but manageable burden. The emphasis across multiple studies on multidisciplinary approaches reflects the complex, multi-organ nature of irAEs requiring diverse specialist input.

The convergence on early recognition and prompt treatment as success factors suggests that outcomes depend less on the specific immunosuppressive regimen than on diagnostic speed and treatment initiation. This finding has important implications for healthcare delivery, highlighting the need for systematic monitoring protocols and trained networks rather than solely focusing on specialized treatment algorithms.

## References

1. [T. Eigentler, et al. (2016). Diagnosis, monitoring and management of immune-related adverse drug reactions of anti-PD-1 antibody therapy. Cancer Treatment Reviews](/content/review/5a61fe78-a415-4e62-b29a-0f18bc45fb72/source/ss-26548696/index.html)
2. [J. Weber, et al. (2016). Management of Adverse Events Following Treatment With Anti-Programmed Death-1 Agents. The Oncologist](/content/review/5a61fe78-a415-4e62-b29a-0f18bc45fb72/source/ss-43720122/index.html)
3. [G. O’Kane, et al. (2017). Monitoring and Management of Immune-Related Adverse Events Associated With Programmed Cell Death Protein-1 Axis Inhibitors in Lung Cancer. The Oncologist](/content/review/5a61fe78-a415-4e62-b29a-0f18bc45fb72/source/ss-3739836/index.html)
4. [J. Patrinely, et al. (2021). Chronic Immune-Related Adverse Events Following Adjuvant Anti-PD-1 Therapy for High-risk Resected Melanoma. JAMA Oncology](/content/review/5a61fe78-a415-4e62-b29a-0f18bc45fb72/source/ss-232356085/index.html)
5. [L. Hofmann, et al. (2016). Cutaneous, gastrointestinal, hepatic, endocrine, and renal side-effects of anti-PD-1 therapy. European Journal of Cancer](/content/review/5a61fe78-a415-4e62-b29a-0f18bc45fb72/source/ss-32836348/index.html)
6. [D. Iacono, et al. (2020). Management of immune-related adverse events: A single-center retrospective analysis in a real-world scenario. Journal of Clinical Oncology](/content/review/5a61fe78-a415-4e62-b29a-0f18bc45fb72/source/ss-219778051/index.html)
7. [C. Owen, et al. (2021). Delayed immune-related adverse events with anti-PD1-based immunotherapy in melanoma. Annals of Oncology](/content/review/5a61fe78-a415-4e62-b29a-0f18bc45fb72/source/ss-232774817/index.html)
8. [S. Vardhana, et al. (2018). Strategies for Recognizing and Managing Immune-Mediated Adverse Events in the Treatment of Hodgkin Lymphoma with Checkpoint Inhibitors. The Oncologist](/content/review/5a61fe78-a415-4e62-b29a-0f18bc45fb72/source/ss-51929819/index.html)
9. [L. Zimmer, et al. (2016). Neurological, respiratory, musculoskeletal, cardiac and ocular side-effects of anti-PD-1 therapy. European Journal of Cancer](/content/review/5a61fe78-a415-4e62-b29a-0f18bc45fb72/source/ss-29575910/index.html)
10. [S. Hoa, et al. (2021). Preexisting autoimmune disease and immune-related adverse events associated with anti-PD-1 cancer immunotherapy: a national case series from the Canadian Research Group of Rheumatology in Immuno-Oncology. Cancer Immunology and Immunotherapy](/content/review/5a61fe78-a415-4e62-b29a-0f18bc45fb72/source/ss-231650058/index.html)