Cancer Genetics and Epigenetics, 2025, Vol.13, No.6, 300-309 http://medscipublisher.com/index.php/cge 300 Review and Progress Open Access Advances in the Efficacy and Safety of Immune Checkpoint Inhibitors in Solid Tumors Hui Xu Tianjin Medical University Cancer Institute and Hospital, Hexi, 300210, Tianjin, China Corresponding email: xuhui@163.com Cancer Genetics and Epigenetics, 2025, Vol.13, No.6 doi: 10.5376/cge.2025.13.0030 Received: 07 Oct., 2025 Accepted: 13 Nov., 2025 Published: 25 Dec., 2025 Copyright © 2025 Xu, This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Xu H., 2025, Advances in the efficacy and safety of immune checkpoint inhibitors in solid tumors, Cancer Genetics and Epigenetics, 13(6): 300-309 (doi: 10.5376/cge.2025.13.0030) Abstract This study explores the latest developments of immune checkpoint inhibitors in the treatment of solid tumors. This type of drug helps the immune system attack tumors by blocking new targets such as PD-1/PD-L1, CTLA-4, LAG-3 and TIGIT, effectively prolonging the survival time of patients in various cancers including lung cancer, melanoma and kidney cancer. The article analyzed the key factors influencing the therapeutic effect, such as PD-L1 level, the number of tumor mutations, MSI/dMMR status, tumor microenvironment and the composition of intestinal microbiota. Meanwhile, immunotherapy may cause immune-related side effects involving multiple organs, which need to be handled in a standardized manner. The combined application with chemotherapy, targeted therapy, radiotherapy, or the simultaneous blocking of two immune targets and other strategies have shown potential to improve therapeutic effects. Future research will focus on developing more precise biomarker systems, exploring new immune targets, developing individualized vaccines, and designing artificial intelligence-assisted treatments. Keywords Immune checkpoint inhibitors (ICIs); PD-1/PD-L1 and CTLA-4; Immunotherapy for solid tumors; Immune-related adverse events (irAEs); Combination therapy and emerging targets 1 Introduction The immune system is of great significance in identifying and eliminating cancer cells. However, tumors can evade the surveillance of the immune system in various ways, especially by using immune checkpoint pathways such as PD-1, PD-L1 and CTLA-4. These checkpoints are molecules that maintain immune balance and prevent the immune system from attacking its own tissues. However, in a tumor environment, they are overly activated, thereby suppressing the ability of immune cells to attack tumors, leading to uncontrolled proliferation and metastasis of cancer cells. It has been discovered that immune checkpoints are the key factors for tumors to achieve immune escape. This discovery has driven the research and development of immune checkpoint inhibitors (ICIs for short), which can be regarded as a breakthrough achievement in the field of cancer treatment. ICIs contains antibodies against PD-1, PD-L1 and CTLA-4, which can reactivate the function of T cells and thereby enhance the body's immune response against tumors. After the first ICIs drug, ipilimumab (anti-CTLA-4), was approved, nivolumab and pembrolizumab (both anti-PD-1 drugs) followed one after another. These therapies have achieved very significant clinical effects in the treatment of various solid tumors, including melanoma, non-small cell lung cancer and renal cell carcinoma. Their application has completely transformed the model of cancer treatment, bringing about a sustained therapeutic response for patients with advanced cancer and simultaneously improving their survival rate (Hodi et al., 2010). This study will explore the latest application progress of ICIs in the treatment of solid tumors and further discuss its latest safety data. Meanwhile, we will consider how to better utilize these drugs in our future clinical work. By collating the existing research results, it is hoped to provide assistance to relevant researchers and clinicians, and to have a clearer understanding of the development direction of tumor immune checkpoint therapy and the current problems that need to be solved.
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