Keio Cancer Center, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
Research and Development Department, Division of Pharmacovigilance, Bristol-Myers Squibb K.K., Shinjuku-ku, Tokyo, Japan.
Future Oncol. 2018 Dec;14(30):3187-3198. doi: 10.2217/fon-2018-0509. Epub 2018 Sep 6.
Immune-related gastrointestinal toxicities (irGI) are well-known adverse events (AEs) with immune checkpoint inhibitors. The aim of this review was to present clinical data from 82 cases to provide information to clinicians who face real-world challenges among their patients with irGI AEs. The findings of this review support the use of the current management guidelines. By analyzing the treatment courses and outcomes of all cases identified, our review recommends that recurrent cases be treated carefully regardless of the grade of diarrhea at the onset of events. Earlier gastroenterology consultation and computed tomography/endoscopy diagnosis are essential, especially when an irGI AE recurs or worsens during steroid tapering. We would also suggest earlier decision to add immunosuppressant agents, particularly for recurrent cases.
免疫相关胃肠道毒性（irGI）是免疫检查点抑制剂的已知不良反应（AE）。本综述的目的是呈现 82 例临床数据，为面临 irGI AE 患者实际挑战的临床医生提供信息。本综述的研究结果支持当前管理指南的使用。通过分析所有确诊病例的治疗过程和结果，我们的综述建议，无论腹泻事件发生时的严重程度如何，对复发性病例都要谨慎治疗。早期进行胃肠病学咨询和 CT/内镜诊断至关重要，特别是在 irGI AE 在类固醇减量过程中复发或加重时。我们还建议更早决定添加免疫抑制剂，特别是对于复发性病例。
