Safety Challenges of Cancer Immunotherapy in Solid Tumors: From Mechanisms to Clinical Practice

The field of immunotherapy has rapidly transformed the management of solid tumors, delivering meaningful survival benefits and changing the prognostic outlook for patients across multiple cancer types. Despite its remarkable efficacy, immunotherapy introduces a complex safety profile distinguished by a broad and sometimes unpredictable spectrum of immune-related adverse events (irAEs). These toxicities, driven by immune system hyperactivation and loss of self-tolerance, may manifest acutely or even months after therapy cessation, affecting nearly every organ system with consequences ranging from mild discomfort to life-threatening reactions. Recent years have seen progress in understanding irAEs through clinical trials and translational research, but substantial gaps persist in their comprehensive characterization, especially in heterogeneous real-world clinical scenarios, combination therapy regimens, special populations, and longitudinal patient follow-up. Current debates center on optimal monitoring, pathophysiological mechanisms, long-term risk, and the best strategies for early detection and intervention.This Research Topic aims to consolidate and advance multidisciplinary research on the safety of immunotherapy in solid tumors, with a particular focus on immune-related adverse events. Central goals include elucidating the biological and immunological mechanisms underpinning irAEs, establishing robust predictive and prognostic biomarkers, and identifying patient-, disease-, and treatment-related factors that contribute to heightened risk. The initiative encourages the exploration of established and emerging methods to prevent, recognize, monitor, and manage immune-related toxicities and to critically appraise how these strategies translate into practical guidance for clinicians. By fostering collaboration among oncologists, immunologists, translational researchers, and allied health professionals, this topic seeks to maximize the benefits of immunotherapy while maintaining patient safety and quality of life.The scope of this Research Topic encompasses clinical, translational, and real-world studies that enhance our understanding of immune-mediated toxicities in solid tumors, with a special emphasis on actionable insights and multidisciplinary management. To gather further knowledge within this area, we welcome articles addressing, but not limited to, the following themes:- Characterization and mechanisms of immune-related adverse events in solid tumors.- Safety profiles of immune checkpoint inhibitors and new immunotherapeutic agents.- Toxicities associated with combination therapies, including immunotherapy–chemotherapy, immunotherapy–targeted therapy, and dual immunotherapy regimens.- Predictive and prognostic biomarkers for immunotherapy-related toxicity and risk stratification models.- Strategies for the management of acute and chronic immune-related toxicities.- Safety of immunotherapy in special patient populations (e.g., elderly, frail, those with pre-existing autoimmune diseases, organ dysfunction).- Real-world data, pharmacovigilance, and registries examining immunotherapy safety.- Long-term safety, survivorship, and late effects in immunotherapy recipients.Please note that manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases that are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of the scope of this Research Topic. Topic editors: Luca Porcu, Chiara Lazzari, Carlo Messina, Alessandro Tomelleri Source: https://www.frontiersin.org/research-topics/80070/safety-challenges-of-cancer-immunotherapy-in-solid-tumors-from-mechanisms-to-clinical-practice