Management of liver and gastrointestinal toxicity induced by immune checkpoint inhibitors: Position statement of the AEEH-AEG-SEPD-SEOM-GETECCU

Gastroenterol Hepatol. 2024 Apr;47(4):401-432. doi: 10.1016/j.gastrohep.2023.10.009. Epub 2024 Jan 15.
[Article in English, Spanish]

Abstract

The development of the immune checkpoint inhibitors (ICI) is one of the most remarkable achievements in cancer therapy in recent years. However, their exponential use has led to an increase in immune-related adverse events (irAEs). Gastrointestinal and liver events encompass hepatitis, colitis and upper digestive tract symptoms accounting for the most common irAEs, with incidence rates varying from 2% to 40%, the latter in patients undergoing combined ICIs therapy. Based on the current scientific evidence derived from both randomized clinical trials and real-world studies, this statement document provides recommendations on the diagnosis, treatment and prognosis of the gastrointestinal and hepatic ICI-induced adverse events.

Keywords: Colitis; Diarrea; Diarrhea; Drug-induced liver injury; Efectos adversos inmunomediados; Hepatitis; Hepatotoxicidad; Immune checkpoint inhibitors; Immune-related adverse events; Immunotherapy; Inhibidores de checkpoint inmunológicos; Inmunoterapia; Toxicidad; Toxicity.

Publication types

  • Practice Guideline

MeSH terms

  • Colitis* / chemically induced
  • Colitis* / drug therapy
  • Gastrointestinal Diseases* / chemically induced
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects
  • Liver
  • Neoplasms*
  • Prognosis

Substances

  • Immune Checkpoint Inhibitors