In some severe cases refractory to corticosteroids blocking of tumour necrosis factor (TNF)-α with infliximab, blocking of the interleukin-6 receptor (IL-6R) with tocilizumab, intravenous immunoglobulins (IVIGs) and mycophenolate mofetil may be beneficial.9,10 When symptoms of the irAR are severe initiation of corticosteroids cannot be postponed and empirical antimicrobial therapy can be started concurrently with corticosteroids and discontinued when infection is excluded.10 The gene discussed is IL6R; the disease is infection.