{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:13:01Z","timestamp":1791573181335,"version":"4.3.4"},"reference-count":177,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T00:00:00Z","timestamp":1641427200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Immune checkpoint inhibitors are monoclonal antibodies that are used to treat over one in three cancer patients. While they have changed the natural history of disease, prolonging life and preserving quality of life, they are highly active in less than 40% of patients, even in the most responsive malignancies such as melanoma, and cause significant autoimmune side effects. Licenced biomarkers include tumour Programmed Death Ligand 1 expression by immunohistochemistry, microsatellite instability, and tumour mutational burden, none of which are particularly sensitive or specific. Emerging tumour and immune tissue biomarkers such as novel immunohistochemistry scores, tumour, stromal and immune cell gene expression profiling, and liquid biomarkers such as systemic inflammatory markers, kynurenine\/tryptophan ratio, circulating immune cells, cytokines and DNA are discussed in this review. We also examine the influence of the faecal microbiome on treatment outcome and its use as a biomarker of response and toxicity.<\/jats:p>","DOI":"10.3390\/diagnostics12010124","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T01:15:26Z","timestamp":1641518126000},"page":"124","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Cancer Immunotherapy with Immune Checkpoint Inhibitors-Biomarkers of Response and Toxicity; Current Limitations and Future Promise"],"prefix":"10.3390","volume":"12","author":[{"given":"Brian","family":"Healey Bird","sequence":"first","affiliation":[{"name":"School of Medicine, University College Cork, T12 K8AF Cork, Ireland"},{"name":"Bon Secours Hospital, T12 K8AF Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9833-170X","authenticated-orcid":false,"given":"Ken","family":"Nally","sequence":"additional","affiliation":[{"name":"School of Biochemistry and Cell Biology, University College Cork, T12 K8AF Cork, Ireland"},{"name":"APC Microbiome Ireland, University College Cork, T12 K8AF Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1828-5708","authenticated-orcid":false,"given":"Karine","family":"Ronan","sequence":"additional","affiliation":[{"name":"Department of Oncology, St. Vincent\u2019s University Hospital, D04 T6F4 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard","family":"Clarke","sequence":"additional","affiliation":[{"name":"APC Microbiome Ireland, University College Cork, T12 K8AF Cork, Ireland"},{"name":"Department of Psychiatry, University College Cork, T12 K8AF Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Amu","sequence":"additional","affiliation":[{"name":"Cancer Research at UCC, University College Cork, T12 K8AF Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8997-2639","authenticated-orcid":false,"given":"Ana S.","family":"Almeida","sequence":"additional","affiliation":[{"name":"APC Microbiome Ireland, University College Cork, T12 K8AF Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4993-4563","authenticated-orcid":false,"given":"Richard","family":"Flavin","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Trinity College Dublin, D08 NHY1 Dublin, Ireland"},{"name":"St. James\u2019s Hospital Dublin, D08 NHY1 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8628-5814","authenticated-orcid":false,"given":"Stephen","family":"Finn","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Trinity College Dublin, D08 NHY1 Dublin, Ireland"},{"name":"St. James\u2019s Hospital Dublin, D08 NHY1 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1001\/jamaoncol.2020.5012","article-title":"Multisystem Immune-Related Adverse Events Associated With Immune Checkpoint Inhibitors for Treatment of Non\u2013Small Cell Lung Cancer","volume":"6","author":"Shankar","year":"2020","journal-title":"JAMA Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1146\/annurev-cancerbio-030419-033604","article-title":"Biomarkers for Response to Immune Checkpoint Blockade","volume":"4","author":"Ganesan","year":"2020","journal-title":"Annu. 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