Macovei Oprescu Anca, Tulin Raluca, Slavu Iulian, Venter Dana Paula, Oprescu Constantin
Gastroenterology, Agrippa Ionescu Emergency Clinical Hospital, Bucharest, ROU.
Gastroenterology, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU.
Cureus. 2021 Nov 27;13(11):e19945. doi: 10.7759/cureus.19945. eCollection 2021 Nov.
Immune checkpoint inhibitors (ICIs) are currently an important component of the standard first-line treatment for many neoplasms. Some guidelines recommend ICIs as adjuvant treatment. With their increased use, the incidence of associated immune-mediated adverse reactions will also increase. A significant proportion of these reactions is represented by immune-mediated diarrhea or colitis, hepatitis, and immune-mediated pancreatic damage. The present review aims to highlight the new trends related to the diagnosis and treatment of these adverse effects depending on their degree, from the perspective of the gastroenterologist. To accomplish this, a literature search was performed, and 30 publications were considered relevant (according to the Population, Intervention, Comparison, Outcomes, and Study [PICOS] criteria). The information about each of the three toxicities in this paper was structured in two categories such as differential diagnosis and treatment. This review aims not only to increase awareness of these side effects in the gastroenterology community but also to promote the development of new treatment guidelines with contributions from gastroenterologists.
免疫检查点抑制剂（ICIs）目前是许多肿瘤标准一线治疗的重要组成部分。一些指南推荐将ICIs作为辅助治疗。随着其使用的增加，相关免疫介导不良反应的发生率也会上升。这些反应中有很大一部分表现为免疫介导的腹泻或结肠炎、肝炎以及免疫介导的胰腺损伤。本综述旨在从胃肠病学家的角度，根据这些不良反应的严重程度，突出与其诊断和治疗相关的新趋势。为此，进行了文献检索，有30篇出版物被认为相关（根据人群、干预措施、对照、结局和研究[PICOS]标准）。本文中关于这三种毒性的信息分为鉴别诊断和治疗两类。本综述不仅旨在提高胃肠病学界对这些副作用的认识，还旨在推动胃肠病学家参与制定新的治疗指南。
