Gastrointestinal and Hepatic Toxicities of Checkpoint Inhibitors: Algorithms for Management

Am Soc Clin Oncol Educ Book. 2018 May 23:38:13-19. doi: 10.1200/EDBK_100013.

Abstract

Gastrointestinal toxicities are among the leading causes of immune-related adverse effects of checkpoint blockade. These adverse events can be severe enough to require interruption or withdrawal of immune checkpoint blockade therapy. Patients with immune-related adverse effects require early recognition with an evaluation to rule out alternative etiologies and effective management to minimize complications. This article reviews the gastrointestinal and hepatic toxicities of the antibodies that target immune checkpoints CTLA-4 and PD-1/PD-L1 and provides an approach to their diagnosis and management.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / adverse effects*
  • Antineoplastic Agents, Immunological / therapeutic use
  • B7-H1 Antigen / antagonists & inhibitors
  • Biomarkers
  • Biomarkers, Tumor
  • CTLA-4 Antigen / antagonists & inhibitors
  • Colitis / diagnosis
  • Colitis / etiology
  • Colitis / therapy
  • Diarrhea / diagnosis
  • Diarrhea / etiology
  • Diarrhea / therapy
  • Gastrointestinal Tract / drug effects*
  • Gastrointestinal Tract / pathology
  • Humans
  • Liver / drug effects*
  • Liver / pathology
  • Liver Diseases / diagnosis
  • Liver Diseases / etiology
  • Liver Diseases / therapy
  • Molecular Targeted Therapy / adverse effects*
  • Pancreatitis / diagnosis
  • Pancreatitis / etiology
  • Pancreatitis / therapy

Substances

  • Antineoplastic Agents, Immunological
  • B7-H1 Antigen
  • Biomarkers
  • Biomarkers, Tumor
  • CD274 protein, human
  • CTLA-4 Antigen
  • CTLA4 protein, human