Balancing Treatment Benefits and Risks of Severe Adverse Effects of Immunotherapy in Cancer: A Systematic Review

Abstract

Background: Melanoma has shown resistance to conventional treatments, resulting in poor prognoses. Recent advancements in immunotherapy have improved patient outcomes. However, these therapies are associated with severe adverse reactions, raising concerns about their safety. Methods: A systematic review was conducted to evaluate the incidence and severity of adverse effects in melanoma patients undergoing immunotherapy compared to those receiving standard chemotherapy. Literature was sourced from Ovid Medline, CINAHL, and Scopus. After screening, 14 articles were selected based on inclusion and exclusion criteria. Results: The review revealed that ICIs are linked to a higher incidence of severe adverse events compared to traditional therapies. Of the included studies, six focused on severe reactions to ICIs, while others discussed general toxicities, risk factors, management strategies, and potential predictive tools. Notably, findings indicated that approximately 25.1% of patients treated with ICIs experienced immune-related adverse events. Conclusion: While ICIs have improved melanoma treatment, the increased risk of severe adverse reactions poses significant clinical challenges. Future research should focus on identifying mechanisms underlying these severe reactions and developing predictive tools.