Rocha Marta, Correia de Sousa João, Salgado Marta, Araújo António, Pedroto Isabel
Department of Gastroenterology, Hospital de Santo António/Centro Hospitalar do Porto, Porto, Portugal.
Institute of Biomedical Sciences Abel Salazar, Porto, Portugal.
GE Port J Gastroenterol. 2019 Jul;26(4):268-274. doi: 10.1159/000494569. Epub 2018 Dec 17.
Immune checkpoint inhibitors have shown anti-tumour activity in cancers such as melanoma, renal cell carcinoma, non-small-cell lung cancer, urothelial carcinoma, colorectal cancer, and Hodgkin's lymphoma. Though immune checkpoint inhibitors have revolutionized the treatment and prognosis of some advanced malignancies, they are also associated with a significant risk of immune-related adverse events. These adverse events can occur in any organ system, but gastrointestinal side effects are among the most commonly reported, with manifestations ranging from mild diarrhoea to severe colitis, sharing some features with inflammatory bowel disease. Anticipating a greater use of these drugs in the future, gastroenterologists should expect to be increasingly faced with gastrointestinal immune-related adverse events. Knowledge of these toxicities, as well as effective management algorithms, is essential to enable early diagnosis and treatment, decreasing morbidity and mortality. We reviewed the currently available literature on gastrointestinal toxicity induced by immune checkpoint inhibitors, namely the clinical features, diagnosis, and management.
免疫检查点抑制剂已在黑色素瘤、肾细胞癌、非小细胞肺癌、尿路上皮癌、结直肠癌和霍奇金淋巴瘤等癌症中显示出抗肿瘤活性。尽管免疫检查点抑制剂彻底改变了一些晚期恶性肿瘤的治疗和预后，但它们也与免疫相关不良事件的重大风险相关。这些不良事件可发生于任何器官系统，但胃肠道副作用是最常报告的副作用之一，其表现从轻度腹泻到严重结肠炎不等，与炎症性肠病有一些共同特征。预计未来这些药物的使用会增加，胃肠病学家应预计会越来越多地面临胃肠道免疫相关不良事件。了解这些毒性以及有效的管理算法对于早期诊断和治疗、降低发病率和死亡率至关重要。我们回顾了目前关于免疫检查点抑制剂引起的胃肠道毒性的文献，即临床特征、诊断和管理。
