Characteristics, treatment, and outcome of diverticulitis after immune checkpoint inhibitor treatment in patients with malignancies

Thomas, Austin R.; Eyada, Mostafa; Kono, Michiko; Varatharajalu, Krishnavathana; Lu, Yang; Xu, Guofan; Panneerselvam, Kavea; Shatila, Malek; Altan, Mehmet; Wang, Jennifer; Thompson, John A.; Zhang, Hao Chi; Khan, Muhammad Ali; Raju, Gottumukkala S.; Thomas, Anusha Shirwaikar; Wang, Yinghong

doi:10.1007/s00432-022-04405-3

Cited by 1 publication

(1 citation statement)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When PD-1 inhibitors and CTLA4 inhibitors are used in combination for renal cell carcinoma, colorectal cancer, melanoma, small cell lung cancer (SCLC), and hepatocellular carcinoma, the incidence of colitis is higher for a 3 mg/kg dosage of ipilimumab and a 1 mg/kg dosage of nivolumab than a 1 mg/kg dosage of ipilimumab and a 3 mg/kg dosage of nivolumab [23,24]. Microscopic colitis can occur during ICI therapy; intestinal perforation and death are both reported while using ICIs following ipilimumab treatment [25]. Specific risk factors for the development of ICI enterocolitis are still not well established.…”

Section: Epidemiologymentioning

confidence: 99%

Checkpoint Inhibitor-Induced Colitis: An Update

Losurdo,

Angelillo,

Favia

et al. 2023

Biomedicines

View full text Add to dashboard Cite

Immunotherapy with immune checkpoint inhibitors (ICIs) nowadays has indications for several solid tumors. The current targets for ICIs are CTLA-4, PD-1, and PD-L1 receptors. Despite the clinical advantages derived from ICIs, a variety of side effects are linked to overstimulation of the immune system. Among these, ICI-related colitis is one of the most common, with a disabling impact on the patient. Diarrhea, abdominal pain, abdominal distension, cramping, and hematochezia are the most common ICI enterocolitis presenting symptoms. The most frequently used grading system for assessment of the severity of ICI enterocolitis is called the Common Terminology Criteria for Adverse Events (CTCAE) grading. With regard to the histological picture, there is no specific feature; however, microscopic damage can be classified into five types: (1) acute active colitis, (2) chronic active colitis, (3) microscopic colitis-like, (4) graft-versus-host disease-like, and (5) other types. Supportive therapy (oral hydration, a bland diet without lactose or caffeine, and anti-diarrheal agents) is indicated in mild colitis. Symptomatic treatment alone or with loperamide, a low-fiber diet, and spasmolytics are recommended for low-grade diarrhea. In more severe cases, corticosteroid treatment is mandatory. In refractory cases, off-label use of biological therapies (infliximab or vedolizumab) was proposed.

show abstract

Section: Epidemiologymentioning

confidence: 99%