Is there a period of time after which you would not resume ICI after a patient has had an irAE and required a prolonged steroid taper?

Typically if a patient has required treatment with steroids for four to six months, it was because their irAE was significant (grade 2-4) and refractory to initial treatment. If the patient received combination immunotherapy, such as anti-CTLA-4 and anti-PD-1 agents, one could consider resuming the anti-PD-1 agent alone as these agents are associated with lower rates of irAE. For irAEs of grade 2 or 3, consultation with a specialist with expertise in the particular irAE experienced by a patient is warranted prior to resuming immunotherapy (i.e. consulting a dermatologist for a patient with a grade 3 rash). Alternative immunosuppressive agents, such as infliximab, methotrexate, and sulfasalazine, can be considered in those patients who are u...