Open accessPosition article and guidelinesournal forImmunoTherapy of CancerSociety for Immunotherapy of Cancer(SITC)consensus definitions for immuneImmunothercheckpoint inhibitor-associated immune-related adverse events(irAEs)terminologyJarushka Naidoo,2.3 Catherine Murphy,.5 Michael B Atkins,Julie R Brahmer,'Stephane Champiat,David Feltquate,Lee M Krug,10publishedJavid Moslehi,M Catherine Pietanza,2 Joanne Riemer,13 Caroline Robert,14Elad Sharon,15 Maria E Suarez-Almazor,16 Karthik Suresh,Michelle Turner,7Jeffrey Weber,1 Laura C Cappelli9.1136/jitc-To cite:Naidoo J,Murphy C,ABSTRACTunderstood.ICI-mediated disruptionof-2022Atkins MB,et al.Society forImmune-related adverse events (irAEs)associated withcentral and peripheral toleranceis thoughtImmunotherapy of Cancerimmune checkpoint inhibitor(ICl)therapy may varySITC consensus definitionsto be a primary driver of irAEs.Humoralsubstantially in their clinical presentation,includingimmunity,cross-presentation of shared6398for immune checkpointinhibitor-associated immune-natural history,outcomes to treatment,and patterns.Thetumor and self antigens,and epitoperelated adverse events (irAEs)application of clinical guidelines for irAE management canspreadingmay also contribute to the develop-terminology.Jouma/forbe challenging for practitioners due to a lack of commonor consistently applied teminology.Furthermore,given thement of toxicity.Other factors that have beenImmunoTherapy of Cancer2023:11:e006398.dot10.1136/growing body of clinical experience and published data onlinked to irAE development include organ-Marchjtc-2022-006398irAEs,there is a greater appreciation for the heterogeneousspecific expression of immune checkpointsnatural histories,responses to treatment,and patterns(eg,CTLA-4 on pituitary tissues,5 PD-L1 in2023Accepted 27 February 2023of these toxicities,which is not currently reflected inrenal epithelium'),genetic risk factors,"andirAE guidelines.Furthermore,there are no prospectivethe composition of the gut microbiota.trial data to inform the management of the distinctThe clinical spectrum of irAEs is vast andpresentations of irAEs.Recognizing a need for uniformalmost every organ system may be affected.AsDownloadedterminology for the natural history,response to treatment,the immunotherapy community accumulatesand patterns of irAEs,the Society for Immunotherapy ofCancer (SITC)convened a consensus panel composed ofexperience in the diagnosis and managementfromleading intemational experts from academic medicine,of irAEs,an appreciation has emerged thatindustry,and regulatory agencies.Using a modified Delphithe natural history of irAEs may be separatedconsensus process,the expert panel developed clinicalinto distinct clinical courses:self-limited,definitions for irAE terminology used in the literature,waxing and waning,or chronic.Similarly,http://jitc.bmj.encompassing terms related to irAE natural history (ie,as more irAEs are treated with corticoste-re-emergent,chronic active,chronic inacti
