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Immune checkpoint inhibitors (ICIs) can cause liver and pancreatic injury, including hepatitis and pancreatitis. Diagnosis involves excluding other causes, and treatment may require stopping ICIs and using immunosuppression.

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Area of Science:

  • Oncology
  • Immunology
  • Gastroenterology

Background:

  • Immune checkpoint inhibitors (ICIs) are widely used in cancer therapy.
  • Hepatotoxicity and pancreatic injury are known adverse events associated with ICI treatment.
  • These toxicities can range from asymptomatic enzyme elevations to severe, life-threatening conditions.

Purpose of the Study:

  • To summarize the spectrum of gastrointestinal toxicities associated with immune checkpoint inhibitors.
  • To discuss the diagnostic approaches and management strategies for ICI-induced liver and pancreatic injuries.

Main Methods:

  • Review of existing literature on ICI-induced hepatotoxicity, pancreatitis, cholecystitis, and cholangitis.
  • Analysis of clinical presentations, diagnostic criteria, and treatment outcomes.

Main Results:

  • Hepatotoxicity presents as asymptomatic transaminase elevation or symptomatic hepatitis.
  • Pancreatic injury includes asymptomatic lipase elevation or acute pancreatitis.
  • Cholecystitis and cholangitis are less common but reported adverse events of ICI therapy.

Conclusions:

  • ICI-induced liver and pancreatic toxicities require careful diagnosis by excluding other causes.
  • Management involves ICI discontinuation and immunosuppression for severe cases.
  • Further research is needed to establish optimal treatment protocols for ICI-induced pancreatitis.