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Updated: Jul 24, 2026

An Intestine/Liver Microphysiological System for Drug Pharmacokinetic and Toxicological Assessment
08:59

An Intestine/Liver Microphysiological System for Drug Pharmacokinetic and Toxicological Assessment

Published on: December 3, 2020

Colon chaos: when drugs turn against your gut

Malek Shatila1, Yinghong Wang2, Anusha Shirwaikar Thomas2

  • 1Wayne State University/Detroit Medical Center, Department of Internal Medicine, Detroit, Michigan.

Current Opinion in Gastroenterology
|November 6, 2025
PubMed
Abstract

Insights

Immune-mediated diarrhea and colitis (IMDC) is a severe toxicity of immune checkpoint inhibitors (ICIs). This review updates management guidelines for IMDC, incorporating recent findings on epidemiology, evaluation, and treatment.

Area of Science:

  • Oncology
  • Immunology
  • Gastroenterology

Background:

  • Immune checkpoint inhibitors (ICIs) are increasingly used in cancer therapy.
  • Immune-mediated diarrhea and colitis (IMDC) is a common and severe adverse event associated with ICIs.
  • Existing guidelines for managing IMDC may not reflect the latest scientific understanding.

Purpose of the Study:

  • To review recent advances in understanding Immune-mediated diarrhea and colitis (IMDC).
  • To propose an updated management algorithm for IMDC based on current literature.
  • To address the need for optimized treatment strategies for ICI-related toxicities.

Main Methods:

  • Comprehensive literature review of recent studies on IMDC.
  • Analysis of epidemiological data, including incidence and risk factors.
  • Evaluation of diagnostic and therapeutic modalities for IMDC.

Main Results:

  • Significant progress has been made in understanding IMDC epidemiology and the role of stool biomarkers.
  • There is a notable lack of data regarding optimal treatment options and long-term outcomes for IMDC.
  • Recent findings necessitate an update to current management protocols for IMDC.

Conclusions:

  • This review synthesizes recent advances in IMDC knowledge.
  • An updated management algorithm for IMDC is proposed, enhancing previous guidelines.
  • Optimizing IMDC management is crucial given the expanding use of ICIs.
Keywords:
immune checkpoint inhibitorsimmune-mediated diarrhea and colitisinfliximabvedolizumab

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