{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T01:37:33Z","timestamp":1773797853571,"version":"3.50.1"},"reference-count":29,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>With increasing use of immune checkpoint inhibitors (ICIs), effective management of immune-related adverse events (irAEs) has become a critical concern. This study aimed to identify the detection triggers of irAEs and provide insights for improving their management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This retrospective analysis included 1,237 patients treated with ICIs between 2014 and 2023. irAEs were categorized into three groups based on their detection triggers: symptom-dominant irAEs (&gt;80% of cases identified through subjective symptoms), test-dominant irAEs (&gt;80% of cases detected via clinical examinations), and mixed-type irAEs (meeting neither criterion).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among the 1,237 patients, 547 (44.2%) experienced 797 irAEs. Symptom-dominant irAEs included skin toxicity (all-grade: 17.3%, grade \u22653: 1.1%), colitis (3%, 1.4%), musculoskeletal toxicity (1.9%, 0.6%), type 1 diabetes (0.6%, 0.6%), nervous system toxicity (0.6%, 0.4%), and ocular toxicity (0.4%, 0%). Test-dominant irAEs included thyroid dysfunction (11.7%, 0.3%), hepatitis (6.5%, 3.2%), nephritis (1.9%, 0.4%), pancreatitis (1.5%, 1.1%), and hematological toxicity (0.6%, 0.3%). Mixed-type irAEs included pneumonitis (10.6%, 2.7%), adrenal insufficiency or hypophysitis (5.2%, 2.5%), and cardiovascular toxicity (0.8%, 0.2%). Mixed-type irAEs were associated with significantly higher rates of grade \u22653 events (33.2%) and unscheduled hospital visits (26.8%) than other irAEs. Furthermore, mixed-type irAEs identified through clinical examination generally exhibited milder severity than those detected based on subjective symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Considering irAE detection triggers, incidence, and severity, this study highlights skin toxicity, colitis, pneumonitis, and adrenal insufficiency as high-priority conditions for patient education. After treatment initiation, test-dominant irAEs require appropriate diagnostic work-ups, symptom-dominant irAEs emphasize the importance of patient interviews, and mixed-type irAEs benefit from a combination of these strategies. This comprehensive strategy may improve irAE detection and management, ultimately enhancing patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/op-24-01032","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T15:59:09Z","timestamp":1749571149000},"page":"463-473","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":2,"title":["Comprehensive Analysis of Detection Triggers for Immune-Related Adverse Events: Implications for Patient Education and Management"],"prefix":"10.1200","volume":"22","author":[{"given":"Haruna","family":"Minami","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5444-2443","authenticated-orcid":false,"given":"Ryosuke","family":"Matsukane","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2651-3472","authenticated-orcid":false,"given":"Sai","family":"Yasukochi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Hirota","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0507-7309","authenticated-orcid":false,"given":"Mayako","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1703481"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2112651"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2302983"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2020-001754"},{"key":"e_1_3_7_6_2","first-page":"271","article-title":"Immune checkpoint inhibitor therapy: Key principles when educating patients","volume":"23","author":"Wood LS","year":"2019","unstructured":"Wood LS, Moldawer NP, Lewis C: Immune checkpoint inhibitor therapy: Key principles when educating patients. 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