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Immune Checkpoint Inhibitor-Induced Colitis: Diagnosis and Management

Caroline Prieux-Klotz1, Marie Dior2,3, Diane Damotte4

  • 1Department of Gastroenterology, Cochin Teaching Hospital, 27, rue du faubourg Saint Jacques, 75014, Paris, France. prieuxcaroline@gmail.com.

Targeted Oncology
|May 26, 2017
PubMed

Insights

Immune checkpoint inhibitors can cause gastrointestinal side effects like diarrhea and colitis in up to 30% of patients. Early diagnosis and management with corticosteroids or infliximab are crucial for severe cases.

Area of Science:

  • Oncology
  • Gastroenterology
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICIs) are increasingly used for various cancers.
  • ICI therapy can lead to immune-related adverse events, particularly gastrointestinal toxicity.
  • Gastrointestinal side effects, including diarrhea and colitis, affect up to 30% of patients.

Purpose of the Study:

  • To outline the clinical presentation and management of ICI-mediated gastrointestinal side effects.
  • To emphasize the importance of early recognition and intervention for severe colitis.
  • To highlight the need for collaboration between oncologists and gastroenterologists.

Main Methods:

  • Review of clinical data and management strategies for ICI-induced gastrointestinal toxicity.
  • Endoscopic and histopathological comparison of ICI-induced colitis with inflammatory bowel disease (IBD) flares.
  • Discussion of treatment protocols including corticosteroids and infliximab.

Main Results:

  • ICI-induced colitis shares endoscopic and histopathological features with IBD flares.
  • Corticosteroids are the first-line treatment for ICI-induced diarrhea and colitis.
  • Infliximab is effective in corticosteroid-refractory cases.
  • Endoscopic evaluation is recommended for suspected severe colitis but should not delay treatment.

Conclusions:

  • Effective management of ICI-induced gastrointestinal side effects requires prompt recognition and treatment.
  • A multidisciplinary approach involving oncologists and gastroenterologists is essential.
  • Patient education and clear management guidelines are critical for optimal outcomes.

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