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Jastreboff, A

Common triggers include: Foods : histamine-rich foods (aged cheese, alcohol), fermented foods, shellfish Temperature extremes Exercise or physical pressure Environmental toxins Emotional stress Infections (viral, bacterial, parasitic) Medications : NSAIDs, opioids, certain anesthetics Hormonal shifts (e.g., during menstruation) Understanding personal triggers is essential to managing MCAS successfully

This shift in the tumor immune landscape creates a more favorable context for immune checkpoint inhibitors (ICIs) to exert their therapeutic effects, as the enhanced immune activation overcomes prior resistance mechanisms (82, 84)