AGA Clinical Practice Update on Diagnosis and Management of Immune Checkpoint Inhibitor Colitis and Hepatitis: Expert Review

Gastroenterology. 2021 Mar;160(4):1384-1393. doi: 10.1053/j.gastro.2020.08.063. Epub 2020 Oct 17.


Background & aims: Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape for oncology, leading to durable remissions in a subset of patients, but also a broad range of potentially life-threatening inflammatory toxicities, many of which involve the gastrointestinal (GI) tract and liver. The purpose of this expert review was to update gastroenterologists on the gastrointestinal and hepatic toxicities of ICIs and provide best practice advice on their diagnosis and management.

Methods: The evidence reviewed in this work combines the expert clinical opinion of the authors with a comprehensive search of several English-language databases and a manual review of relevant publications.

Keywords: Adverse Event; Enterocolitis; Hepatitis; Immune Checkpoint Inhibitor; Toxicity.

Publication types

  • Practice Guideline
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chemical and Drug Induced Liver Injury / diagnosis*
  • Chemical and Drug Induced Liver Injury / immunology
  • Chemical and Drug Induced Liver Injury / therapy
  • Colitis / chemically induced
  • Colitis / diagnosis*
  • Colitis / immunology
  • Colitis / therapy
  • Gastroenterology / methods
  • Gastroenterology / standards*
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Neoplasms / drug therapy
  • Neoplasms / immunology
  • Practice Guidelines as Topic*
  • Societies, Medical / standards
  • United States


  • Immune Checkpoint Inhibitors