The development of immune-checkpoint inhibitors (ICIs) has heralded a new era in cancer treatment, enabling the possibility of long-term survival in patients with metastatic disease, and providing new therapeutic indications in earlier-stage settings. As such, characterizing the long-term implications of receiving ICIs has grown in importance. An abundance of evidence exists describing the acute clinical toxicities of these agents, although chronic effects have not been as well catalogued. Nonetheless, emerging evidence indicates that persistent toxicities might be more common than initially suggested. While generally low-grade, these chronic sequelae can affect the endocrine, rheumatological, pulmonary, neurological and other organ systems. Fatal toxicities also comprise a diverse set of clinical manifestations and can occur in 0.4–1.2% of patients. This risk is a particularly relevant consideration in light of the possibility of long-term survival. Finally, the effects of immune-checkpoint blockade on a diverse range of immune processes, including atherosclerosis, heart failure, neuroinflammation, obesity and hypertension, have not been characterized but remain an important area of research with potential relevance to cancer survivors. In this Review, we describe the current evidence for chronic immune toxicities and the long-term implications of these effects for patients receiving ICIs.

免疫检查点抑制剂（ICIs）的发展预示着癌症治疗的新时代，使转移性疾病患者长期生存成为可能，并为早期环境提供了新的治疗适应症。因此，描述接受 ICI 的长期影响变得越来越重要。尽管慢性影响尚未得到很好的分类，但已有大量证据描述了这些药物的急性临床毒性。尽管如此，新出现的证据表明，持续毒性可能比最初建议的更为常见。虽然这些慢性后遗症通常程度较低，但会影响内分泌、风湿病、肺、神经和其他器官系统。致命毒性还包括多种临床表现，可能发生在 0.4-1.2% 的患者中。考虑到长期生存的可能性，这种风险是一个特别相关的考虑因素。最后，免疫检查点阻断对多种免疫过程的影响，包括动脉粥样硬化、心力衰竭、神经炎症、肥胖和高血压，尚未得到表征，但仍然是与癌症幸存者潜在相关的重要研究领域。在这篇综述中，我们描述了慢性免疫毒性的当前证据以及这些效应对接受 ICI 的患者的长期影响。