Immune checkpoint inhibitor-mediated colitis in gastrointestinal malignancies and inflammatory bowel disease

Alexa R Weingarden; Samuel J S Rubin; John Gubatan

doi:10.4251/wjgo.v13.i8.772

Immune checkpoint inhibitor-mediated colitis in gastrointestinal malignancies and inflammatory bowel disease

World J Gastrointest Oncol. 2021 Aug 15;13(8):772-798. doi: 10.4251/wjgo.v13.i8.772.

Authors

Alexa R Weingarden¹, Samuel J S Rubin², John Gubatan³

Affiliations

¹ Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Redwood City, CA 94063, United States. aweingar@stanford.edu.
² Stanford University School of Medicine, Stanford University, Redwood City, CA 94063, United States.
³ Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Redwood City, CA 94063, United States.

Abstract

Immune checkpoint inhibitors (ICI) have markedly changed the landscape of cancer therapy. By re-invigorating the immune system against tumors, ICI provide novel therapeutic options for a broad variety of malignancies, including many gastrointestinal (GI) cancers. However, these therapies can also induce autoimmune-like side effects in healthy tissue across the body. One of the most common of these side effects is ICI-mediated colitis and diarrhea (IMC). Here, we review the incidence and risk of IMC in ICI therapy, with a focus on what is known regarding IMC in patients with GI malignancies. We also discuss data available on the use of ICI and risk of IMC in patients with pre-existing inflammatory bowel disease, as these patients may have increased risk of IMC due to their underlying intestinal pathology.

Keywords: Cytotoxic T-lymphocyte antigen 4; Gastrointestinal cancer; Immune checkpoint inhibitors; Inflammatory bowel disease; Programmed cell death protein-1.

Publication types

Review