[Comment] Adjuvant or neoadjuvant treatment with immune checkpoint inhibitors: re-assessing the risk–benefit ratio

In 2012, the first immune checkpoint inhibitor targeting CTLA-4, ipilimumab, received approval for the treatment of metastatic melanoma. Shortly thereafter, PD-1 inhibitors followed suit, and both treatments rapidly established themselves as the standard of care not only for metastatic melanoma but also for various other cancers. Long-term remissions and even potential cure became attainable for patients with metastatic cancers treated with immune checkpoint inhibitors. However, this substantial improvement in survival came with a potential downside in terms of toxicity, because some patients had treatment-related adverse events, some of which might be irreversible or, in a small proportion of cases, fatal.