Immunotherapy and Immune-Related Adverse Events in Cancer

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Immunology and Immunotherapy".

Deadline for manuscript submissions: 31 October 2026 | Viewed by 1548

Editors


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Guest Editor
1. Tumor Clinic, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
2. Department of Gastroenterology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
3. Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia
Interests: immunotherapy; transplantation; hepatology; microbiota; digestive oncology
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Clinic for Tumors, Clinical Hospital Center Rijeka, Rijeka, Croatia
Interests: immunotherapy; supportive care; gastrointestinal cancers
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Immunotherapy has significantly improved survival rates for some cancers, particularly in patients with advanced or metastatic disease. For example, in melanoma, immunotherapy, specifically PD-1 inhibitors, has increased the 5-year survival rate to approximately 50%, according to the Cancer Research Institute. In some cases, combination immunotherapy has shown even more impressive results, with over half of advanced melanoma patients surviving ten years or more. Despite the clinical benefits of the immune checkpoint blockade therapy, its use is associated with a spectrum of side effects, related to the mechanism of action, which is quite different from other systemic therapies such as cytotoxic chemotherapy (CTX). The side effects may involve any organ or system of the body; however, GI, dermatologic, hepatic, endocrine, and pulmonary toxicities predominate, and there should be a high level of suspicion that any changes are treatment-related. The incidence and onset of immune-related adverse effects (irAEs) vary based on the class and dose of ICPi administered, the type of cancer, and factors related to the patients. These events occur because immunotherapy, which boosts the immune system to fight cancer, can sometimes cause the immune system to attack healthy tissues. IrAEs can range from mild and easily managed to severe and life-threatening. With the increasing use of immunotherapy in cancer treatment regimens, it is imperative that clinicians be knowledgeable about the symptoms associated with these agents, how best to monitor them, and their recommended management. The aim of this thematic Special Issue is to cover the diagnosis and treatment of immune-mediated adverse events.

Prof. Dr. Ivana Mikolašević
Dr. Marin Golčić
Guest Editors

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Keywords

  • immunotherapy
  • cancer
  • PD-1 inhibitors
  • immune-related adverse effects
  • management

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Published Papers (1 paper)

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Review

25 pages, 658 KB  
Review
Immune-Mediated Colitis Induced by Immune Checkpoint Inhibitors: Pathophysiology, Clinical Management, and the Emerging Role of Fecal Microbiota Transplantation
by Zeljka Belosic Halle, Vedran Tomasic, Alen Biscanin, Petra Cacic, Ivona Saric, Sanda Mustapic, Josip Stojic, Kresimir Luetic, Dinko Bekic, Matej Paic, Domagoj Micetic, Irena Krznaric Zrnic, Ivna Olic, Melanija Razov Radas, Iva Skocilic, Marin Golčic, Laura Rados, Jasna Radic, Juraj Prejac and Ivana Mikolasevic
Biomedicines 2026, 14(3), 683; https://doi.org/10.3390/biomedicines14030683 - 16 Mar 2026
Viewed by 1198
Abstract
Background/Objectives: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of various malignancies, but their use is frequently accompanied by immune-related adverse events, among which immune-mediated colitis (IMC) represents one of the most common and clinically significant gastrointestinal toxicities. IMC may lead to treatment [...] Read more.
Background/Objectives: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of various malignancies, but their use is frequently accompanied by immune-related adverse events, among which immune-mediated colitis (IMC) represents one of the most common and clinically significant gastrointestinal toxicities. IMC may lead to treatment interruption, increased morbidity, and compromised quality of life. This review aims to provide a comprehensive overview of the pathophysiology, risk factors, diagnosis, management, and emerging therapeutic strategies with particular emphasis on the role of the gut microbiota and fecal microbiota transplantation (FMT). Methods: This review integrates current international guidelines, meta-analyses, clinical trials, and recent translational studies addressing IMC. The available evidence on immunological mechanisms, predictive biomarkers, clinical presentation, diagnostic algorithms, and treatment options was critically synthesized to outline a structured and multidisciplinary management approach. Results: IMC is driven by dysregulated immune activation, cytokine release, and alterations in gut microbiota. Incidence and severity vary according to ICI class, combination regimens, tumor type, and patient-related factors. Diagnosis requires exclusion of infectious causes, laboratory assessment, and endoscopic and histologic evaluation with CTCAE-based severity grading. Corticosteroids remain the cornerstone of first-line therapy, while infliximab and vedolizumab are effective in steroid-refractory cases. Emerging therapies, including JAK inhibitors and FMT, have shown promising results in refractory disease. Conclusions: IMC is a complex and potentially severe complication of ICI therapy that necessitates early recognition, accurate grading, and individualized, multidisciplinary management. Severity-guided treatment, timely escalation to biologics, and careful balancing of immunosuppression with antitumor efficacy are essential for optimal outcomes. Future research should focus on biomarker validation, microbiome-targeted therapies, and prospective trials to refine therapeutic algorithms and define the optimal role and timing of FMT in clinical practice. Full article
(This article belongs to the Special Issue Immunotherapy and Immune-Related Adverse Events in Cancer)
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