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GSH is synthesized from cysteine, glutamate, and glycine by the ATP-dependent enzyme -glutamyl-cysteine (-GC) ligase (GCL) synthetase, which is composed of the -GC ligase catalytic subunit (GCLC), the -GC modifier subunit (GCLM), and GSH synthetase (GSS) 24

The most commonly observed irAEs, particularly in treatments combining immune checkpoint inhibitors with chemotherapy, include arthralgia, thyroid dysfunction (both hypothyroidism and hyperthyroidism), transaminitis, dermatologic toxicities, pneumonitis, and colitis