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. 2024 Jun 14;24:733. doi: 10.1186/s12885-024-12468-3

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© The Author(s) 2024

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 1 — Spontaneous immune mediated disease and MEDALLION study hypothesis. Established immune-mediated diseases are well-studied, and their risk factors are increasingly understood in the general population (left panel). In cancer patients, we hypothesise that checkpoint blockade actively “lowers the threshold” at which immune tolerance is lost, permitting systematic monitoring of the events that trigger clinically manifest disease (right panel). The MEDALLION cohort represents a human “model” of incipient immune dysregulation within which we will test this hypothesis.)