Safety Profile of Checkpoint Inhibitors Across ESCC and Gastric/GEJ Tumors

This discussion reviews key safety considerations for immune checkpoint inhibitors used in advanced esophageal squamous cell carcinoma (ESCC) and gastric or gastroesophageal junction (GEJ) cancers. The discussion centers on PD-1 inhibitors, such as nivolumab, pembrolizumab, and tislelizumab, which share broadly similar immune-related toxicity patterns. Common events include thyroid dysfunction and other endocrinopathies, with less frequent but clinically important toxicities such as pneumonitis, colitis, and hepatitis. The segment emphasizes that grade 3 or higher immune-related adverse events are generally uncommon and can be managed effectively with early recognition and guideline-based interventions. It also notes that higher rates of severe adverse events observed in combination regimens typically relate to the chemotherapy backbone rather than the checkpoint inhibitor itself. Across trials, no PD-1 agent has shown unexpected or distinct toxicity signals in these gastrointestinal cancer settings, supporting their use as manageable components of modern treatment strategies.