Toward nursing-integrated biomarker surveillance for immune-related adverse events during immune checkpoint inhibitor therapy

Immune checkpoint inhibitors (ICIs) have transformed cancer care but can cause immune-related adverse events (irAEs) involving almost any organ system. Delayed recognition may permit reversible inflammation to progress to organ dysfunction, treatment interruption, prolonged immunosuppression, or death. Biomarker surveillance offers an objective complement to symptom assessment, yet no single marker is sufficiently accurate for universal prediction. This Mini Review examines the mechanistic basis and clinical evidence for nursing-led biomarker monitoring during ICI therapy. Targeted autoantibody, cytokine, or immune-cell assays may support selected clinical evaluations, whereas germline, T-cell receptor, and microbiome signatures remain investigational. Dynamic changes are generally more informative than isolated values, but interpretation is complicated by cancer burden, infection, concomitant treatment, and pre-existing disease. Nurses are positioned to connect serial laboratory trends with patient-reported symptoms, vital signs, treatment timing, and escalation pathways. Prospective studies are needed to validate multimarker panels and determine whether biomarker-informed nursing pathways reduce severe irAEs without unnecessary testing or interruption of effective immunotherapy.