Immune-mediated colitis after immune checkpoint inhibitor therapy

Area of Science:

• Oncology
• Immunology
• Gastroenterology

Background:

• Immune checkpoint inhibitors (ICIs) improve cancer outcomes but can cause immune-mediated colitis (ImC).
• ImC results from the inhibition of natural anti-inflammatory mechanisms, leading to significant morbidity and mortality.
• Understanding ImC's pathophysiology is crucial for managing this adverse event.

Purpose of the Study:

• To review the clinical and pathophysiological aspects of immune-mediated colitis (ImC) induced by ICIs.
• To highlight current and novel therapeutic strategies for managing ImC.
• To emphasize the need for treatments that balance cancer response and side effect management.

Main Methods:

• Literature review of clinical studies and pathophysiological research on ICI-induced colitis.
• Analysis of the roles of T cells, myeloid cells, and gut microbiota in ImC development.
• Evaluation of existing and emerging treatment options for ImC.

Main Results:

• ICIs activate T cells and recruit myeloid cells in the colon, contributing to inflammation.
• Gut microbiota play a significant role in immune dysregulation and barrier dysfunction in ImC.
• Current therapies include corticosteroids, anti-TNF-α, and anti-integrin α4β7 antibodies.

Conclusions:

• ICI-induced colitis is a significant concern requiring effective management strategies.
• Novel therapeutic approaches are essential to avoid impairing anti-tumor immunity.
• Further research into ImC pathogenesis and treatment is warranted.