Understanding and treating the inflammatory adverse events of cancer immunotherapy

During the past decade, immunotherapies have made a major impact on the treatment of diverse types of cancer. Inflammatory toxicities are not only a major concern for Food and Drug Administration (FDA)-approved checkpoint blockade and chimeric antigen receptor (CAR) T cell therapies, but also limit the development and use of combination therapies. Fundamentally, these adverse events highlight the intricate balance of pro- and anti-inflammatory pathways that regulate protective immune responses. Here, we discuss the cellular and molecular mechanisms of inflammatory adverse events, current approaches to treatment, as well as opportunities for the design of immunotherapies that limit such inflammatory toxicities while preserving anti-tumor efficacy. Inflammatory toxicities are critical challenges hindering the success of immunotherapy in revolutionizing oncology care. Understanding the biology of inflammatory adverse events will fuel the effort of advancing immunotherapy design that curbs toxicities without sacrificing anti-tumor efficacy.