AOGRAdvances in Obstetrics and Gynecology Research3083-48722981-8060Bio-Byword Scientific Publishing Pty. Ltd.10.26689/aogr.v4i1.14103ArticleRecognition and Management of Adverse Reactions to Immunotherapy in Gynecologic Oncology: A Comprehensive Reviewhttps://artdesignp.com/journal/AOGR/4/1/10.26689/aogr.v4i1.14103XuGuangjin,LiXueyan,XuShilian,HuangQiaoyao,PengYongpai,YangXinru,ZhengXiaohang2026412026-03-10Background: Immune checkpoint inhibitors (ICIs) have transformed gynecologic cancer treatment, but their use is complicated by immune-related adverse events (irAEs) that pose significant clinical challenges. Objective: This review systematically summarizes the epidemiology, mechanisms, recognition, and management of irAEs in gynecologic malignancies, highlighting controversies and future directions. Main content: IrAEs occur in a substantial proportion of gynecologic oncology patients, with varying onset and severity profiles by ICI class and cancer type. Pathophysiological mechanisms include off-target T-cell activation and molecular mimicry. Recognition requires vigilance toward multi-organ toxicities. Management follows CTCAE-guided tiered strategies: mild events permit continued immunotherapy with supportive care, while severe toxicities require treatment interruption and corticosteroids, with escalation to second-line agents in refractory cases. Special considerations include combination regimens, elderly patients, and immunotherapy rechallenge decisions. Conclusion: Optimal irAE management requires multidisciplinary collaboration, individualized risk assessment, and standardized protocols. Future research should focus on predictive biomarkers and preventive strategies to maximize efficacy while ensuring safety.

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