Immunotherapy-Induced Colitis: An Emerging Problem for the Hospitalist

Area of Science:

• Oncology
• Immunology
• Gastroenterology

Background:

• Immune checkpoint inhibitors (ICIs) are increasingly used for melanoma treatment, significantly improving patient survival.
• ICIs modulate the immune system, leading to potential autoimmune-like adverse events.
• The gastrointestinal (GI) tract is a frequent target, with complications ranging from diarrhea to severe colitis.

Purpose of the Study:

• To review the gastrointestinal (GI) adverse events associated with immune checkpoint inhibitors (ICIs).
• To familiarize hospitalists with the mechanism of action and potential complications of ICIs.
• To emphasize the importance of early diagnosis and treatment for ICI-induced GI complications.

Main Methods:

• Case-oriented review of literature.
• Discussion of the mechanism of action of ICIs.
• Analysis of clinical manifestations and management strategies for GI adverse events.

Main Results:

• ICI-induced GI adverse events are common and varied, including diarrhea, colitis, and perforation.
• Understanding the immunologic basis of these events is key to management.
• Prompt recognition and intervention can mitigate severe outcomes.

Conclusions:

• Hospitalists must be aware of the spectrum of GI adverse events associated with ICIs.
• Early diagnosis and management are critical to minimize morbidity and mortality.
• This review provides a framework for managing these complex cases.