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Non-invasive Assessment of the Efficacy of New Therapeutics for Intestinal Pathologies Using Serial Endoscopic Imaging of Live Mice
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Endoscopic insights into digestive-related adverse effects of immune checkpoint inhibitors: A narrative review

Grigorios Petrousis1,2, Sylwester Szczegielniak3, Haider Sabhan4,5

  • 1Centre for Digestive Health, Department of Gastroenterology, Dermatovenereology and Rheumatology, Karolinska University Hospital, Stockholm 17164, Sweden.

World Journal of Gastrointestinal Endoscopy
|July 18, 2025
PubMed

Insights

Immune checkpoint inhibitors (ICIs) improve cancer survival but can cause gastrointestinal side effects. This review details these immune-related adverse events (irAEs), focusing on endoscopic findings and management.

Area of Science:

  • Oncology
  • Immunology
  • Gastroenterology

Background:

  • Immune checkpoint inhibitors (ICIs) offer significant survival benefits for cancer patients.
  • Common ICIs target programmed cell death-1 (PD-1), programmed cell death-ligand 1 (PD-L1), and cytotoxic T lymphocyte antigen 4 (CTLA-4) receptors.
  • ICI therapy is associated with immune-related adverse events (irAEs), particularly affecting the gastrointestinal tract.

Purpose of the Study:

  • To provide an overview of primary gastrointestinal irAEs associated with ICIs.
  • To highlight endoscopic manifestations of gastrointestinal irAEs.
  • To analyze pathogenesis, diagnosis, histology, and treatment of gastrointestinal irAEs.

Main Methods:

  • Comprehensive literature search of PubMed, Web of Science, Embase, and Cochrane Library.
  • Focus on studies detailing gastrointestinal immune-related adverse events.
  • Inclusion of data on endoscopic findings, mechanisms, diagnostics, histology, and therapeutics.

Main Results:

  • Gastrointestinal irAEs are a significant concern impacting patient quality of life.
  • Endoscopic findings provide crucial diagnostic information for irAEs.
  • Understanding pathogenetic mechanisms aids in developing effective management strategies.

Conclusions:

  • Gastrointestinal irAEs are a critical clinical challenge in ICI therapy.
  • Endoscopic evaluation is essential for diagnosing and managing these events.
  • Further research into pathogenesis and targeted therapies is warranted for optimal patient care.
Keywords:
ColitisEndoscopyEnteritisGastritisGastrointestinal tractImmune checkpoint inhibitorsImmune-related adverse eventsToxicity

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