Abstract
Immune checkpoint inhibitors have revolutionized management of advanced malignancies. However, their use is frequently complicated by immune related adverse events (irAEs), immune checkpoint inhibitor enterocolitis (IMEC) being the most common toxicity. IMEC is a distinct form of bowel inflammation that is highly reminiscent of idiopathic inflammatory bowel disorders (Crohn's disease, ulcerative colitis, and microscopic colitis). In this review, we highlight the similarities and differences in the pathophysiology, clinical presentation, evaluation, and management of these overlapping immune inflammatory bowel disorders. IMEC is an inflammatory bowel disease–like irAE that occurs as an outcome of disruption of intestinal immune surveillance and gut dysbiosis. Clinical and endoscopic presentation of both entities is strikingly similar, which often guides management. Though well established in inflammatory bowel disease, little is known about the long term outcomes of IMEC.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 878-890 |
| Number of pages | 13 |
| Journal | Clinical Gastroenterology and Hepatology |
| Volume | 21 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2023 |
Funding
Anusha Shirwaikar Thomas and Yinghong Wang conceptualized the manuscript, reviewed the available literature, ensured that accuracy and integrity were preserved at all stages, agreed to be accountable for all aspects of the study, contributed to the writing of the manuscript, with input from all authors. Stephen Hanauer contributed to reviewing and writing the manuscript and providing expert feedback and input. All authors read and approved the final manuscript. The authors disclose no conflicts.
Keywords
- Adverse Events
- Immune Checkpoint Inhibitor
- Inflammatory Bowel Disease
ASJC Scopus subject areas
- Gastroenterology
- Hepatology