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Management of Patients With Immune Checkpoint Inhibitor-Induced Enterocolitis: A Systematic Review.

Author information

Affiliations

  • 1. Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance Publique-Hopitaux de Paris, Le Kremlin Bicêtre, France; Paris Saclay University, Le Kremlin Bicêtre, France; INSERM, U1193, Paul-Brousse University Hospital, Hepatobiliary Centre, Villejuif, France.
      Authors
    • Collins M 1
    (1 author)
  • 2. Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance Publique-Hopitaux de Paris, Le Kremlin Bicêtre, France.
      Authors
    • Soularue E 2
    • Marthey L 2
    (2 authors)
  • 3. Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance Publique-Hopitaux de Paris, Le Kremlin Bicêtre, France; Paris Saclay University, Le Kremlin Bicêtre, France; INSERM 1018, UPS, UVSQ Institut Gustave Roussy, Villejuif Cedex, France.
      Authors
    • Carbonnel F 3
    (1 author)

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 31 Jan 2020, 18(6):1393-1403.e1
https://doi.org/10.1016/j.cgh.2020.01.033 PMID: 32007539 

Review

Abstract 

Immune checkpoint inhibitors (ICIs) have improved the treatment of several cancers. These drugs increase T-cell activity and the antitumor immune response but also have immune-related adverse effects that can affect the gastrointestinal (GI) tract. These adverse effects have been observed in 7% to 30% of patients treated with ICIs. As the number of diseases treated with ICIs increases, gastroenterologists will see more patients with ICI-induced GI adverse events. We performed a systematic review of the incidence, risk factors, clinical manifestations, and management of the adverse effects of ICIs on the GI tract. Treatment with anti-cytotoxic T-lymphocyte-associated antigen-4 often causes severe enterocolitis, whereas treatment with inhibitors of programmed cell death 1 have less frequent and more diverse adverse effects. Management of patients with GI adverse effects of ICIs should involve first ruling out other disorders, followed by assessment of severity, treatment with corticosteroids, and rapid introduction of infliximab therapy for nonresponders.

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Read article at publisher's site: https://doi.org/10.1016/j.cgh.2020.01.033

Read article for free, from open access legal sources, via Unpaywall: http://manuscript.elsevier.com/S1542356520301129/pdf/S1542356520301129.pdfUnpaywall

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Funding 

Funders who supported this work.

Fondation pour la Recherche Médicale doctoral (1)