Focus on Immune Checkpoint Inhibitors-related Intestinal Inflammation: From Pathogenesis to Therapeutical Approach

Inflamm Bowel Dis. 2024 Jun 3;30(6):1018-1031. doi: 10.1093/ibd/izad229.

Abstract

Recently, antitumor immunotherapies have witnessed a breakthrough with the emergence of immune checkpoint inhibitors (ICIs) including programmed cell death-1 (PD-1), programmed cell death-ligand 1 (PD-L1), and cytotoxic T lymphocyte antigen 4 (CTLA-4) inhibitors. Unfortunately, the use of ICIs has also led to the advent of a novel class of adverse events that differ from those of classic chemotherapeutics and are more reminiscent of autoimmune diseases, the immune-related adverse events (IRAEs). Herein, we performed an insight of the main IRAEs associated with ICIs, focusing on gastroenterological IRAEs and specifically on checkpoint inhibitor colitis, which represents the most widely reported IRAE to date. We comprehensively dissected the current evidence regarding pathogenesis, diagnosis, and management of ICIs-induced colitis, touching upon also on innovative therapies.

Keywords: colitis; gut microbiota; immune checkpoint inhibitors; immune system; immuno-related adverse effects.

Plain language summary

Immune checkpoint inhibitors (ICIs)-induced colitis is the most widely reported immune-related adverse event following the use of ICIs. In this review, we comprehensively discuss current evidence regarding pathogenesis, diagnosis, and management of ICIs-induced colitis, including a focus on innovative therapies.

Publication types

  • Review

MeSH terms

  • Colitis* / chemically induced
  • Humans
  • Immune Checkpoint Inhibitors* / adverse effects
  • Immunotherapy / adverse effects
  • Immunotherapy / methods
  • Neoplasms / drug therapy
  • Neoplasms / immunology

Substances

  • Immune Checkpoint Inhibitors