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Management of Patients With Immune Checkpoint Inhibitor-Induced Enterocolitis: a Systematic Review.
Clinical Gastroenterology and Hepatology ( IF 7.958 ) Pub Date : 2020-01-30 , DOI: 10.1016/j.cgh.2020.01.033
Michael Collins,Emilie Soularue,Lysiane Marthey,Franck Carbonnel

Immune checkpoint inhibitors (ICIs) have improved the treatment of several cancers. These drugs increase T-cell activity and the anti-tumor immune response but also have immune-related adverse effects that can affect the gastrointestinal (GI) tract. These adverse effects are observed in 7%-30% of patients treated with ICIs. As the number of diseases treated with ICIs increases, gastroenterologists will see more patients with ICI-induced GI adverse events. We performed a systematic review of the incidence, risk factors, clinical manifestations, and management of the adverse effects of ICIs on the GI tract. Treatment with anti-CTLA4 often causes severe enterocolitis, whereas treatment with inhibitors of PDCD1 (also called PD1) has less frequent and more diverse adverse effects. Management of patients with GI adverse effects of ICIs should involve first ruling out other disorders, followed by assessment of severity, treatment with corticosteroids, rapid introduction of infliximab therapy for non-responders.
更新日期:2020-01-31

 

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