[Hepatic and digestive adverse events of immune checkpoint inhibitors (anti-CTLA-4 and, anti-PD-1/PD-L1): A clinico-pathological review]

Ann Pathol. 2018 Dec;38(6):338-351. doi: 10.1016/j.annpat.2018.07.005. Epub 2018 Aug 22.
[Article in French]

Abstract

Immune checkpoint inhibitors (anti-CTLA-4 and anti-PD-1/PD-L1) have recently revolutionized anti-cancer therapy and are nowadays used in different metastatic cancers. These treatments may induce immune-related adverse events which frequently involve the digestive tract and, to a less extent the liver. The tissular injuries, which are still poorly characterized from a morphological and physiopathological point of view, may lead on one side to the interruption of a life-saving treatment and on the other side to the development of severe complications, if not death. Therefore, it is crucial to diagnose as early as possible and treat these digestive and hepatic adverse effects in an optimal way. This article aims to describe the clinical and pathological presentations of digestive and hepatic adverse events induced by these immunotherapies.

Keywords: Anti-CTLA-4; Anti-PD-1; Colite; Colitis; Effets secondaires; Hepatitis; Hépatite; Immune checkpoint inhibitors; Immune related adverse events; Inhibiteurs du checkpoint immunitaire.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / adverse effects*
  • Antineoplastic Agents, Immunological / therapeutic use
  • Autoimmune Diseases / chemically induced
  • B7-H1 Antigen / antagonists & inhibitors*
  • CTLA-4 Antigen / antagonists & inhibitors*
  • Chemical and Drug Induced Liver Injury / diagnosis
  • Chemical and Drug Induced Liver Injury / epidemiology
  • Chemical and Drug Induced Liver Injury / etiology*
  • Chemical and Drug Induced Liver Injury / pathology
  • Clonal Anergy / drug effects
  • Colitis / chemically induced*
  • Colitis / diagnosis
  • Colitis / epidemiology
  • Colitis / pathology
  • Diagnosis, Differential
  • Early Diagnosis
  • Humans
  • Incidence
  • Ipilimumab / adverse effects
  • Ipilimumab / therapeutic use
  • Lymphocyte Activation / drug effects
  • Lymphoproliferative Disorders / chemically induced
  • Molecular Targeted Therapy / adverse effects*
  • Neoplasms / drug therapy
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors*
  • T-Lymphocytes, Cytotoxic / drug effects
  • T-Lymphocytes, Cytotoxic / immunology

Substances

  • Antineoplastic Agents, Immunological
  • B7-H1 Antigen
  • CD274 protein, human
  • CTLA-4 Antigen
  • Ipilimumab
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor