Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Nov 27;13(11):e19945.
doi: 10.7759/cureus.19945. eCollection 2021 Nov.

Immune Checkpoint Inhibitor-Induced Gastrointestinal Toxicity: The Opinion of a Gastroenterologist

Affiliations
Review

Immune Checkpoint Inhibitor-Induced Gastrointestinal Toxicity: The Opinion of a Gastroenterologist

Anca Macovei Oprescu et al. Cureus. .

Abstract

Immune checkpoint inhibitors (ICIs) are currently an important component of the standard first-line treatment for many neoplasms. Some guidelines recommend ICIs as adjuvant treatment. With their increased use, the incidence of associated immune-mediated adverse reactions will also increase. A significant proportion of these reactions is represented by immune-mediated diarrhea or colitis, hepatitis, and immune-mediated pancreatic damage. The present review aims to highlight the new trends related to the diagnosis and treatment of these adverse effects depending on their degree, from the perspective of the gastroenterologist. To accomplish this, a literature search was performed, and 30 publications were considered relevant (according to the Population, Intervention, Comparison, Outcomes, and Study [PICOS] criteria). The information about each of the three toxicities in this paper was structured in two categories such as differential diagnosis and treatment. This review aims not only to increase awareness of these side effects in the gastroenterology community but also to promote the development of new treatment guidelines with contributions from gastroenterologists.

Keywords: colitis; gastrointestinal; hepatitis; immune-checkpoint inhibitors; pancreatitis; toxicity.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American Society of Clinical Oncology Clinical Practice Guideline. Brahmer JR, Lacchetti C, Schneider BJ, et al. J Clin Oncol. 2018;36:1714–1768. - PubMed
    1. Clinical assessment of immune-related adverse events. Sosa A, Lopez Cadena E, Simon Olive C, Karachaliou N, Rosell R. Ther Adv Med Oncol. 2018;10:1–11. - PMC - PubMed
    1. Acute management of autoimmune toxicity in cancer patients on immunotherapy: common toxicities and the approach for the emergency physician. Lomax AJ, McNeil C. Emerg Med Australas. 2017;29:245–251. - PubMed
    1. Patterns of onset and resolution of immune-related adverse events of special interest with ipilimumab: detailed safety analysis from a phase 3 trial in patients with advanced melanoma. Weber JS, Dummer R, de Pril V, Lebbé C, Hodi FS. Cancer. 2013;119:1675–1682. - PubMed
    1. Immune-checkpoint inhibitor-induced diarrhea and colitis in patients with advanced malignancies: retrospective review at MD Anderson. Wang Y, Abu-Sbeih H, Mao E, et al. J Immunother Cancer. 2018;6:37. - PMC - PubMed

LinkOut - more resources