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While novel cellular and immune-based therapies have fundamentally reshaped oncology, they have also introduced a complex new spectrum of immune-mediated adverse events. 1,2 Management of these toxicities frequently relies on corticosteroidbased regimens, which can be effective and lead to symptom control. 1,2 However, this strategy has important drawbacks: steroids may dampen the anti-tumour efficacy of immune-based therapies, and steroid-induced immunosuppression increases the infection risk and may adversely affect non-relapse morbidity and mortality. 3 These challenges underscore the need for rigorous post-marketing surveillance of advanced therapeutic medicinal products, as well as focused clinical and translational efforts to describe rare and unexpected adverse events and develop tools for early recognition, risk stratification, and optimal management of recurrent and clinically significant toxicities.Immunotherapies and Cell Therapies: A Deeper Evaluation of Advanced Therapeutic Medicinal Products", these issues are addressed from complementary perspectives.Immune checkpoint inhibitors (ICIs) have improved survival across a broad spectrum of malignancies and are nowadays currently standard of care in multiple therapeutic settings. At the same time, they have introduced new immune-mediated toxicities. 4 Cutaneous adverse events are among the most frequent and usually manageable, but in rare cases, severe, life-threatening reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) can occur. 2 In their systematic review, Zhou et al. describe 50 patients reported in 47 publications. They report a mortality of 20%, with infections and tumour progression as leading causes of death, likely reflecting treatment-related immunosuppression. 5 Events typically occurred early (median 23 days after ICI initiation), and death followed a median of 28 days after onset. Poor outcome was associated with TEN phenotype and larger body surface area involvement, while dual ICI therapy correlated with a higher rate of TEN than monotherapy. 5 Corticosteroids and intravenous immunoglobulins were the most frequently used treatments, but in this small cohort, no regimen showed clear superiority. These findings underscore the need for vigilant early monitoring and better therapeutic strategies for suspected ICI-related SJS/TEN. 5 Bispecific antibodies (BsAbs) have rapidly expanded the therapeutic armamentarium options for relapsed or refractory B-cell lymphomas, offering potent T-cell-redirecting activity. 6,7 As their use becomes routine, a systematic understanding of their toxicity spectrum has become essential to optimizing outcomes. The review by Doig and Yannakou provides a comprehensive synthesis of the acute and delayed adverse events (AEs)AEs associated with currently approved BsAbs. Cytokine release syndrome (CRS) remains the most common AE, typically manifesting early and predominantly in low-grade, yet requiring vigilant risk-adapted mitigation strategies. 8 The manuscript underscores how step-up dosing, premedication, and standardized intervention algorithms have improved the safety without compromising efficacy. 8 Neurotoxicity, including immune-effector cell-associated neurotoxicity syndrome (ICANS), although ocurringoccurring less frequently than with CAR -T cell therapy, remains present. 8 The authors reinforce the importance of early recognition and The CRS Map, published on the MINERVA platform, encompasses 24 cell types, 425 entities and 430 interactions, and can be interactively explored and used for data visualization and network analyses, including the overlay of clinical cytokine datasets. 9 This explorable resource supports hypothesis generation, biomarker discovery, and future in silico modelingmodelling that may inform CRS management, prediction, and prevention.Persistent cytopenias following CAR -T cell therapy pose a challenge to clinicians and patients, as it becomes especially important to manage its their consequences: infection, bleeding, and anaemia. Predictive tools can help identify patients at higher risk of developing cytopenias. The CAR-HEMATOTOX is a simple bedside score composed of biomarkers representing a poor haematopoietic reserve (haemoglobin, platelet-and neutrophil count) and inflammatory stressors on marrow function (ferritin and C-reactive protein, CRP). 10 This score has been shown to predict the depth and length of neutropenia, infectious complications 11 and even progression-free survival (PFS) and overall survival (OS). 12 In this issue, Lesan and colleagues further validate this score in an independent German cohort, across multiple CAR -T products. 13 Despite being a small study, the authors identify key predictors of cytopenias following CAR -T cell therapy. In particular, early thrombocytopenia and neutropenia at the time of CRS were strongly associated with CAR-HEMATOTOX, especially pre-existing thrombocytopenia. 13 This is important as this is the timepoint when patients receive immunosuppression for CRS but would equally be at risk of developing infections. In the later phase, high CAR-HEMATOTOX was associated with anaemia. Although the study did not confirm an association between CAR-HEMATOTOX and PFS or OS, the message findings supports using the CAR-HEMATOTOX score prior to infusion and referencing it in post-infusion clinical decision-making.Taken together, this issue brings together essential insights on immune-related adverse events across multiple domains, including real-world evidence, integrative systems approaches, and systematic literature review. As treatments become more complex, pharmacovigilance and high-quality reporting remain crucial to improve our understanding of the safety profiles of novel mechanisms of action, with the potential to ultimately influence patient outcomes. In parallel, a deeper understanding of the underlying mechanisms of these toxicities can inform clinical decision-making and support more personalized and, effective management strategies.