Immune Checkpoint Inhibitor-Associated Colitis and Hepatitis

Area of Science:

• Oncology
• Immunology
• Gastroenterology
• Hepatology

Background:

• Immune checkpoint inhibitors (ICPIs) are monoclonal antibodies targeting CTLA-4, PD-1, and PD-L1.
• ICPIs demonstrate superior durable response rates in metastatic cancers compared to chemotherapy.
• ICPIs can cause immune-related adverse events (irAEs) affecting any organ, including the GI tract and liver.

Purpose of the Study:

• To review the diagnosis and management of ICPI-associated colitis and hepatitis.
• To compare ICPI-related toxicities with sporadic inflammatory bowel disease and autoimmune liver disease.

Main Methods:

• Literature review focusing on ICPI-associated colitis and hepatitis.
• Comparative analysis of ICPI-related toxicities versus idiopathic conditions.

Main Results:

• ICPIs are increasingly used, leading to frequent encounters with ICPI-associated colitis and hepatitis by specialists.
• Understanding and differentiating these irAEs from other conditions is crucial for effective patient care.

Conclusions:

• Gastroenterologists and hepatologists must be prepared to diagnose and manage ICPI-associated colitis and hepatitis.
• Distinguishing ICPI-related toxicities from inflammatory bowel disease and autoimmune liver disease is essential for appropriate treatment strategies.