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Differential diagnosis and management of immune checkpoint inhibitor-induced colitis: A comprehensive review

World Journal of Experimental Medicine 2021年第6期11卷 79-92页

作者： Hua Li Zhi-Yan Fu Mustafa Erdem Arslan Daniel Cho Hwajeong Lee Department of Pathology and Laboratory Medicine Albany Medical CenterAlbanyNY 12208United States Schenectady Pathology Associates Ellis HospitalSchenectadyNY 12308United States

immune checkpoint inhibitors(ICIs)are a new class of cancer pharmacotherapy consisting of antibodies that block inhibitory immune regulators such as cytotoxic T lymphocyte antigen 4,programmed cell death 1 and programmed death-ligand *** blockade by ICIs reactivates a tumor-specific T cell ***-related adverse events can occur in various organs including skin,liver,and gastrointestinal *** to severe colitis is the most common side effect with some experiencing rapid progression to more serious complications including bowel perforation and even *** diagnosis and management of ICI-induced colitis is crucial for optimal ***,its clinical,endoscopic and histopathologic presentations are non-specific and overlap with those of colitis caused by other etiologies,such as infection,medication,graftversus-host disease and inflammatory bowel ***,a definitive diagnosis can only be rendered after these other possible etiologies are *** an extensive clinical,laboratory and radiologic workup is required,making it challenging to arrive at a prompt *** patients experience full resolution of symptoms with corticosteroids and/or *** ICI-induced colitis that is treatment-refractory,small scale studies offer alternative strategies,such as vedolizumab and fecal microbiota *** this review,we focus on the clinical features,differential diagnosis,and management of ICIinduced colitis with special attention to emerging treatment options for treatmentrefractory ICI-induced colitis.

关键词： immune checkpoint inhibitor immune checkpoint inhibitor-induced colitis Infliximab Vedolizumab Graft-versus-host disease Inflammatory bowel disease

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