Faculty, Staff and Student Publications
Publication Date
11-14-2024
Journal
Journal of Immunotherapy of Cancer
Abstract
Gastrointestinal immune-related adverse events (GI irAEs) are common manifestations of immune checkpoint inhibitor (ICI) toxicity. We present a comprehensive systematic review of the incidence, management, and clinical course of irAEs across the entire GI system, including the luminal GI tract, liver, and pancreas. MEDLINE, Embase, Web of Science Core Collection, and Cochrane Library were used to conduct this review. All studies pertaining to GI irAEs were included. Both abstracts and full manuscripts were eligible if they included human subjects and were written in the English language. Articles not available in English, animal studies, or research not specific to GI toxicity of immunotherapy were excluded. We excluded certain article types depending on whether stronger evidence was available in the literature for a specific toxicity, for example, if prospective studies were available on a topic, retrospective studies and case reports were excluded. We extracted a final 166 articles for our review and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for data reporting. Risk of bias tools were not used to evaluate the extracted studies given the narrative nature of this manuscript, but each study was critically appraised by the manuscript writer. We detail the incidence, presentation, evaluation, management, and outcomes of the various GI toxicities that may arise with ICI therapy. Specifically, we discuss the characteristics of upper GI toxicity (esophagitis and gastroenteritis), lower GI toxicity (colitis), hepatobiliary inflammation, pancreatitis, and rarer forms of GI toxicity. We hope this review serves as a useful and accessible clinical tool that helps physicians familiarize themselves with the nuances of gastrointestinal/hepatic/pancreatic ICI toxicity diagnosis and management.
Keywords
Humans, Immune Checkpoint Inhibitors, Gastrointestinal Diseases, Immunotherapy, Pancreatic Diseases, Neoplasms, Immune Checkpoint Inhibitors, Colitis, Immune Checkpoint Inhibitor, Immunotherapy
DOI
10.1136/jitc-2024-009742
PMID
39542654
PMCID
PMC11575294
PubMedCentral® Posted Date
11-14-2024
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Included in
Gastroenterology Commons, Immunotherapy Commons, Oncology Commons, Public Health Commons