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Immune Checkpoint Inhibitor-Induced Colitis: Diagnosis and Management

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Abstract

Immune checkpoint inhibitors are monoclonal antibodies indicated for an increasing number of malignant diseases. These agents can cause specific side effects, which need to be anticipated while clear patterns of management need to be established. Immune checkpoint inhibitor-mediated gastrointestinal side effects, including diarrhea and colitis, occur in up to 30% of patients. Severe colitis can lead to severe dehydration or intestinal perforation. Endoscopic lesions and histopathological features of immune checkpoint inhibitor-induced colitis are similar to an inflammatory bowel disease (IBD) flare. Patients with immune checkpoint inhibitor-induced diarrhea and colitis are treated with corticosteroids. Infliximab can be used in cases of corticosteroid failure. Rectosigmoïdoscopy or colonoscopy should be performed when severe immune checkpoint inhibitor-induced colitis is suspected, but endoscopic investigations should not delay treatment. Specific patient education as well as co-operation between oncologists and gastroenterologists is essential.

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Authors and Affiliations

  1. Department of Gastroenterology, Cochin Teaching Hospital, 27, rue du faubourg Saint Jacques, 75014, Paris, France

    Caroline Prieux-Klotz, Marie Dior, Johann Dreanic, Bertrand Brieau, Catherine Brezault, Vered Abitbol, Stanislas Chaussade & Romain Coriat

  2. Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes, Paris, France

    Marie Dior, Johann Dreanic, Bertrand Brieau, Catherine Brezault, Stanislas Chaussade & Romain Coriat

  3. Department of Pathology, Cochin Teaching Hospital, AP-HP, Paris, France

    Diane Damotte

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  1. Caroline Prieux-Klotz
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  2. Marie Dior
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Correspondence to Caroline Prieux-Klotz.

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Vered Abitbol has acted as a consultant for Hospira and Abbvie, given lectures for Hospira, and received travel support from Takeda, Janssen, and Pfizer. All other authors declare no conflicts of interest.

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Prieux-Klotz, C., Dior, M., Damotte, D. et al. Immune Checkpoint Inhibitor-Induced Colitis: Diagnosis and Management. Targ Oncol 12, 301–308 (2017). https://doi.org/10.1007/s11523-017-0495-4

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