Immune checkpoint inhibitor colitis, a rising issue in targeted cancer therapy era: A literature review DOI Creative Commons
Randy Adiwinata, Kevin Tandarto, Caroline Tanadi

et al.

Romanian Journal of Internal Medicine, Journal Year: 2024, Volume and Issue: 62(3), P. 219 - 230

Published: April 9, 2024

Research advances in the oncology treatment field have led to widespread use of immunotherapy. The usage immune checkpoint inhibitor (ICI) has improved survival cancer patients with metastases. This also rapidly expanding indications for ICI use. However, may lead toxicity, which be immune-related, different organ-specific targets. immune-related adverse events (irAEs) increased morbidity, decreased quality life, and early termination ICI. clinical manifestations irAEs gastrointestinal system are variable, ranging from self-limited life-threatening or fatal events. In this review article, we would like focus on discussing ICI-induced colitis, is one most common tract.

Language: Английский

The JAK-STAT Pathway as a Therapeutic Strategy in Cancer Patients with Immune Checkpoint Inhibitor-Induced Colitis: A Narrative Review DOI Open Access
Antonietta Gerarda Gravina, Raffaele Pellegrino,

Alfonso Esposito

et al.

Cancers, Journal Year: 2024, Volume and Issue: 16(3), P. 611 - 611

Published: Jan. 31, 2024

Immunotherapy has emerged as a pivotal component in the treatment of various malignancies, encompassing lung, skin, gastrointestinal, and head neck cancers. The foundation this therapeutic approach lies immune checkpoint inhibitors (ICI). While ICIs have demonstrated remarkable efficacy impeding neoplastic progression these tumours, their use may give rise to substantial toxicity, notably gastrointestinal domain, where ICI colitis constitutes significant aspect. optimal positioning Janus kinase (JAK)-signal transducer activator transcription (STAT) pathway management remains unclear. Numerous reports highlighted notable improvements through application pan-JAK-STAT inhibitors, with tofacitinib, particular, reporting evident clinical remission colitis. precise mechanism by which JAK-STAT impact pathogenetic process inadequately understood. However, there is speculation regarding potential role modulating memory resident CD8+ T lymphocytes. elucidation requires further extensive robust evidence, ongoing JAK-STAT-based trials are anticipated contribute valuable insights.

Language: Английский

Citations

14
A viable remedy for overcoming resistance to anti-PD-1 immunotherapy: Fecal microbiota transplantation DOI
Yiming Meng, Jing Sun, Guirong Zhang

et al.

Critical Reviews in Oncology/Hematology, Journal Year: 2024, Volume and Issue: 200, P. 104403 - 104403

Published: June 4, 2024

Language: Английский

Citations

6
Checkpoint inhibitor colitis: a gastroenterologists’ perspective DOI
Aditi Kumar,

Hazem Alnatour,

Gabriel Imbianozor

et al.

Frontline Gastroenterology, Journal Year: 2025, Volume and Issue: unknown, P. flgastro - 102905

Published: April 18, 2025

Immune checkpoint inhibitor (ICI) medications are increasingly widely used for the treatment of certain forms cancer. Although they offer significant prognostic benefits, associated with a broad spectrum immune-related adverse effects (irAEs). Checkpoint colitis (CIC) is considered most severe and common cause discontinuation ICI. The risk CIC varies by mechanism action ICI in question whether combination immunotherapy used. diagnosed endoscopically, including histology. Differential diagnoses include infections, cytomegalovirus other irAEs such as thyroiditis, coeliac disease enteritis. Initial management includes temporary cessation administration corticosteroid use escalation to biological refractory cases. Both infliximab vedolizumab have demonstrated efficacy excess 80% cases following three infusions. In selected cases, re-challenge can be attempted similar rates patients without prior CIC. Patients inflammatory bowel exacerbation if treated Despite this, considering benefit from ICI, expert consensus does not contraindicate pre-existing disease.

Language: Английский

Citations

0
Management of refractory checkpoint inhibitor-induced colitis DOI
Anas Zaher, Maria José Albuquerque Santos,

Hassan Elsaygh

et al.

Expert Opinion on Drug Safety, Journal Year: 2025, Volume and Issue: unknown

Published: April 19, 2025

This review discusses the epidemiology, pathophysiology, and factors associated with refractory immune-mediated diarrhea colitis (r-IMDC), emphasizing tailored treatment strategies. The current literature on r-IMDC was reviewed using PubMed (2015-2025), focusing clinical trials, meta-analyses, case reports relevant to its management. Effectively managing is crucial for balancing toxicities antitumor response. Available second third-line management options cases must be carefully evaluated. Future perspectives include development of standardized protocols beyond second-line therapies predictive biomarkers enable personalized treatment.

Language: Английский

Citations

0
New strategies in the diagnosis and treatment of immune-checkpoint inhibitor-mediated colitis DOI Open Access
Tsvetelina Velikova, Boris Krastev, Milena Gulinac

et al.

World Journal of Clinical Cases, Journal Year: 2024, Volume and Issue: 12(6), P. 1050 - 1062

Published: Feb. 20, 2024

Immune-checkpoint inhibitor-mediated colitis (IMC) is an increasingly recognized adverse event in cancer immunotherapy, particularly associated with immune checkpoint inhibitors (ICIs) such as anti-cytotoxic T-lymphocyte antigen-4 and anti-programmed cell death protein-1 antibodies. As this revolutionary immunotherapy gains prominence treatment, understanding, diagnosing, effectively managing IMC becomes paramount. represents a unique challenge due to its immune-mediated nature potential for severe complications. However, precise picture of pathophysiology currently unavailable. Therefore, we aimed summarize the existing data while acknowledging need further research. This comprehensive review explores mechanisms underlying ICIs, gastrointestinal effects, and, particular, IMC's incidence, prevalence, features. Our also emphasizes importance recognizing distinct clinical histopathological features differentiate it from other forms colitis. Furthermore, paper highlights urgent evolving diagnostic methods, therapeutic strategies, multidisciplinary approach manage IMC.

Language: Английский

Citations

2
Enterocolitis and other immunotherapy and targeted therapy-related gastrointestinal manifestations: A review for gastroenterologist DOI Creative Commons

Octavio Gómez Escudero

Revista de Gastroenterología de México (English Edition), Journal Year: 2024, Volume and Issue: 89(1), P. 89 - 105

Published: Jan. 1, 2024

New oncologic treatments, particularly immunotherapy (IT), have revolutionized the treatment of advanced-stage malignant tumors. Immune checkpoint inhibitors are main form IT and act by increasing T cell activity organism's immune response against neoplastic cells. Targeted therapy is another that acts inhibiting oncogenes or inflammation signaling tumor angiogenesis pathways. However, these mechanisms destruction can interfere with host's self-tolerance epithelial tissue repair predispose to system-mediated adverse events affect multiple organs, including digestive tract. The gastrointestinal manifestations damage caused range from low-grade mucositis ulceration, in some cases, necrosis perforation. Any part tract be affected, but there greater involvement small bowel colon, a pattern similar seen inflammatory disease. most common clinical manifestation chronic diarrhea. differential diagnosis includes enteropathogenic infections, especially those opportunistic microorganisms; drug reactions; other malabsorption disorders. Treatment guided severity. Mild cases treated antidiarrheals rehydration outpatient setting; moderate hospitalization, systemic steroids, temporary suspension IT; severe immunosuppressants biologic agents definitive IT. Los nuevos tratamientos oncológicos, particularmente la inmunoterapia han venido revolucionar el tratamiento de neoplasias malignas en estadios avanzados. inhibidores los puntos control son principal forma y actúan aumentando actividad las células respuesta inmune del organismo contra neoplásicas. La terapia blanco es otra que actúa mediante inhibición o vías inflamación angiogénesis tumoral. Sin embargo, estos mecanismos destrucción tumoral pueden interferir con tolerancia huésped reparación tisular epitelial, predisponer efectos secundarios inmunomediados afectar múltiples órganos, incluyendo tracto digestivo. Las manifestaciones gastrointestinales daño por ir desde bajo grado hasta ulceración algunos casos perforación, cualquier parte tubo digestivo, mayor afección intestino delgado un patrón al observado enfermedad inflamatoria intestinal. manifestación clínica más común diarrea crónica. El diagnóstico diferencial incluye infecciones enteropatógenas, gérmenes oportunistas, efecto secundario medicamentos, otros trastornos inflamatorios malabsortivos. depende severidad daño, puede incluir antidiarreicos rehidratación externa leves, hospitalización, esteroides sistémicos suspensión temporal moderados, e inmunosupresores agentes biológicos, definitiva severos.

Language: Английский

Citations

2
JAK Inhibitor Upadacitinib Induces Remission in Refractory Immune‐Related Colitis Triggered by CTLA‐4 and PD‐1 Inhibitor Combination Therapy in Malignant Pleural Mesothelioma: A Case Report DOI Creative Commons
Masashi Kono, Yoriaki Komeda, Hisato Kawakami

et al.

Cancer Reports, Journal Year: 2024, Volume and Issue: 7(10)

Published: Oct. 1, 2024

ABSTRACT Background Immune checkpoint inhibitors have demonstrated efficacy against various cancers; however, there is a rising incidence of immune‐related colitis. Some cases colitis prove resistant to treatment, even with the administration glucocorticoids or infliximab, and currently no established standard treatment for such cases. Case The patient, 73‐year‐old male, had undergone combination therapy malignant pleural mesothelioma 2 years, utilizing both ipilimumab (a CTLA‐4 inhibitor) nivolumab PD‐1 inhibitor). Unfortunately, led side effects, specifically adverse event (irAE) enterocolitis. Steroid infliximab failed improve patient's condition. Treatment tacrolimus was attempted, but patient remained unresponsive. Subsequently, 45 mg upadacitinib, Janus kinase (JAK) inhibitor, administered. Symptoms improved rapidly following upadacitinib administration, endoscopy also revealed positive results. With increasing colitis, some patients become infliximab. In this case, irAE enterocolitis by administration. Conclusion where proves glucocorticoids, tacrolimus, represents potential option as JAK inhibitor.

Language: Английский

Citations

2
State-of-the-Art Cancer Immunotherapies DOI Open Access

Hisashi Nagase,

Takuma Kato, Takayuki Yoshimoto

et al.

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(5), P. 2532 - 2532

Published: Feb. 22, 2024

Cancer immunotherapy is a type of cancer therapy utilizing the immune system to fight against tumors [...]

Language: Английский

Citations

1
Enterocolitis y otras manifestaciones de toxicidad gastrointestinal asociada a inmunoterapia y terapia blanco: una revisión para el gastroenterólogo DOI Creative Commons
O. Gómez-Escudero

Revista de Gastroenterología de México, Journal Year: 2024, Volume and Issue: 89(1), P. 89 - 105

Published: Jan. 1, 2024

Los nuevos tratamientos oncológicos, particularmente la inmunoterapia (IT) han venido a revolucionar el tratamiento de neoplasias malignas en estadios avanzados. inhibidores los puntos control son principal forma IT y actúan aumentando actividad las células T respuesta inmunitaria del organismo contra neoplásicas. La terapia blanco es otra que actúa mediante inhibición oncogenes o vías inflamación angiogénesis tumoral. Sin embargo, estos mecanismos destrucción tumoral pueden interferir con tolerancia huésped reparación tisular epitelial predisponer efectos secundarios inmunomediados afectar múltiples órganos, incluyendo tracto digestivo. Las manifestaciones gastrointestinales daño por ir desde mucositis bajo grado hasta ulceración algunos casos necrosis perforación, cualquier parte tubo digestivo, mayor afección intestino delgado colon, un patrón similar al observado enfermedad inflamatoria intestinal. manifestación clínica más común diarrea crónica. El diagnóstico diferencial incluye infecciones enteropatógenas, gérmenes oportunistas, efecto secundario medicamentos, otros trastornos inflamatorios malabsortivos. depende severidad puede incluir antidiarreicos rehidratación externa leves, hospitalización, esteroides sistémicos suspensión temporal moderados, e inmunosupresores agentes biológicos, definitiva severos. New oncologic treatments, particularly immunotherapy (IT), have revolutionized the treatment of advanced-stage malignant tumors. Immune checkpoint inhibitors are main form and act by increasing cell activity organism's immune response against neoplastic cells. Targeted therapy is another that acts inhibiting or inflammation signaling tumor angiogenesis pathways. However, these mechanisms destruction can interfere with host's self-tolerance epithelial tissue repair predispose to system-mediated adverse events affect multiple organs, including digestive tract. The gastrointestinal manifestations damage caused range from low-grade ulceration, in some cases, perforation. Any part tract be affected, but there greater involvement small bowel pattern seen inflammatory disease. most common clinical manifestation chronic diarrhea. differential diagnosis includes enteropathogenic infections, especially those opportunistic microorganisms; drug reactions; other malabsorption disorders. Treatment guided severity. Mild cases treated antidiarrheals rehydration outpatient setting; moderate hospitalization, systemic steroids, temporary suspension IT; severe immunosuppressants biologic agents definitive IT.

Citations

0
Immune checkpoint inhibitor colitis, a rising issue in targeted cancer therapy era: A literature review DOI Creative Commons
Randy Adiwinata, Kevin Tandarto, Caroline Tanadi

et al.

Romanian Journal of Internal Medicine, Journal Year: 2024, Volume and Issue: 62(3), P. 219 - 230

Published: April 9, 2024

Research advances in the oncology treatment field have led to widespread use of immunotherapy. The usage immune checkpoint inhibitor (ICI) has improved survival cancer patients with metastases. This also rapidly expanding indications for ICI use. However, may lead toxicity, which be immune-related, different organ-specific targets. immune-related adverse events (irAEs) increased morbidity, decreased quality life, and early termination ICI. clinical manifestations irAEs gastrointestinal system are variable, ranging from self-limited life-threatening or fatal events. In this review article, we would like focus on discussing ICI-induced colitis, is one most common tract.

Language: Английский

Citations

0