Although itepekimab/astegolimab/tozorakimab showed favourable safety in asthma/COPD cohorts, oncology patients differ in baseline inflammation, prior therapies and TME composition; consequently dose-finding oncology trials should start with conservative dose-escalation schemas and include PD markers (sST2, intratumoral PD-L1, TIL changes) and TME profiling. The gene discussed is CD274; the disease is chronic obstructive pulmonary disease.