Immunosuppressive Agents and Their Role in Managing Immunotherapy Toxicities in Melanoma

Immune checkpoint inhibitors (IO) have changed the landscape of treatment of advanced cancer. Substantial and durable responses may be experienced in patients who previously had few or no efficacious systemic treatment options available to them. IO are often well tolerated; however, uncontrolled and unexpected off-target effects can occur, resulting in wide-ranging and varied toxicities. This review discusses the current management of organ-specific IO-associated toxicity in metastatic melanoma, with a focus on skin toxicity, colitis, endocrinopathies, and IO-induced kidney injury. Furthermore, we describe the immunology behind IO-induced toxicity, propose improvements on current practice, and highlight areas in need of further research.