{"id":9061,"date":"2023-10-09T12:21:00","date_gmt":"2023-10-09T10:21:00","guid":{"rendered":"https:\/\/www.adacyte.com\/?post_type=scientific-corner&#038;p=9061"},"modified":"2024-04-30T13:51:01","modified_gmt":"2024-04-30T11:51:01","slug":"severe-and-refractory-gastrointestinal-toxicity-due-to-immune-checkpoint-inhibitors-clinical-experience-in-a-tertiary-referral-hospital","status":"publish","type":"scientific-corner","link":"https:\/\/www.adacyte.com\/de\/professional\/scientific-corner\/severe-and-refractory-gastrointestinal-toxicity-due-to-immune-checkpoint-inhibitors-clinical-experience-in-a-tertiary-referral-hospital\/","title":{"rendered":"Severe and refractory gastrointestinal toxicity due to immune checkpoint inhibitors: clinical experience in a tertiary referral hospital"},"content":{"rendered":"<div class=\"post-content max-w-987 mx-auto px-20 lg:px-0\">\n<p>Elena C\u00e9spedes Mart\u00ednez, Virginia Robles Alonso, Claudia Herrera-De Guise, Luis Mayorga, Francesc Casellas, Mar\u00eda Roca-Herrera, Natalia Borruel, Rev Esp Enferm Dig 2023;115(10):567-573<\/p>\n<\/div>\n\n<div class=\"post-content max-w-987 mx-auto px-20 lg:px-0\">\n<p>Introduction: immune checkpoint inhibitors (ICI) are increasingly used to treat several types of cancer. These drugs lead to a wide range of toxicities. Immune-related gastrointestinal adverse events are common and potentially severe. In this manuscript, we recount the real clinical experience in a tertiary center. Methods: a retrospective and observational study was conducted in adult patients under ICI treatment. Included patients had been referred to the Gastrointestinal Service of Hospital Universitario Vall d\u2019Hebron for evaluation of severe toxicities, from January 2017 to January 2020, for whom the clinical, epidemiological and evolutive data were collected. Results: a total of 18 patients were included. Fifty-five percent received anti-programmed cell death protein 1 (PD-1)\/anti-programmed death-ligand 1 (anti PD-L1), 11 % received anti-cytotoxic T lymphocyte antigen 4 (CTLA-4) and 33 % received both treatments. The toxicities were manifested as enterocolitis, microscopic colitis and gastritis. Upper gastrointestinal endoscopy was performed in seven patients; all were proved to have histological changes on duodenum biopsies. Treatment was stopped in all patients and steroids were initiated. Sixty-six per cent achieved clinical remission with steroids. Five patients received anti-TNF treatment (infliximab). Only one of the five had responded. Two anti-TNF refractory patients received ustekinumab, with an appropriate clinical response. One patient received apheresis granulocyte as concomitant treatment. A patient with a steroid-dependent course started vedolizumab. Three patients had other immune-related adverse events. Conclusion: gastrointestinal immune-related adverse events are acquiring a higher profile in daily practice and gastroenterologists play an even greater role in the management of these patients.<\/p>\n<\/div>\n\n<div class=\"post-content max-w-987 mx-auto px-20 lg:px-0\">\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37170542\/\">Severe and refractory gastrointestinal toxicity due to immune checkpoint inhibitors: clinical experience in a tertiary referral hospital &#8211; PubMed (nih.gov)<\/a><\/p>\n<\/div>\n\n<div class=\"post-content max-w-987 mx-auto px-20 lg:px-0\">\n<p><a href=\"https:\/\/www.reed.es\/ArticuloFicha.aspx?id=12705&amp;hst=0&amp;idR=125&amp;tp=1\">REED &#8211; Revista Espa\u00f1ola de Enfermedades Digestivas<\/a><\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Elena C\u00e9spedes Mart\u00ednez, Virginia Robles Alonso, Claudia Herrera-De Guise, Luis Mayorga, Francesc Casellas, Mar\u00eda Roca-Herrera, Natalia Borruel, Rev Esp Enferm Dig 2023;115(10):567-573 Introduction: immune checkpoint inhibitors (ICI) are increasingly used to treat several types of cancer. These drugs lead to a wide range of toxicities. Immune-related gastrointestinal adverse events are common and potentially severe. In [&hellip;]<\/p>\n","protected":false},"template":"","scientific_tags":[781,783,424,691,109,782,269,53,48,280,271,306,88,66],"class_list":["post-9061","scientific-corner","type-scientific-corner","status-publish","hentry","scientific_tags-enterocolitis","scientific_tags-gastritis","scientific_tags-gma","scientific_tags-immune-checkpoint-inhibitors","scientific_tags-infliximab","scientific_tags-microscopic-colitis","scientific_tags-observational","scientific_tags-refractory-patients","scientific_tags-retrospective","scientific_tags-steroids","scientific_tags-study","scientific_tags-ulcerative-colitis","scientific_tags-ustekinumab","scientific_tags-vedolizumab"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Severe and refractory gastrointestinal toxicity due to immune checkpoint inhibitors: clinical experience in a tertiary referral hospital - Adacyte<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.adacyte.com\/professional\/scientific-corner\/severe-and-refractory-gastrointestinal-toxicity-due-to-immune-checkpoint-inhibitors-clinical-experience-in-a-tertiary-referral-hospital\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Severe and refractory gastrointestinal toxicity due to immune checkpoint inhibitors: clinical experience in a tertiary referral hospital - Adacyte\" \/>\n<meta property=\"og:description\" content=\"Elena C\u00e9spedes Mart\u00ednez, Virginia Robles Alonso, Claudia Herrera-De Guise, Luis Mayorga, Francesc Casellas, Mar\u00eda Roca-Herrera, Natalia Borruel, Rev Esp Enferm Dig 2023;115(10):567-573 Introduction: immune checkpoint inhibitors (ICI) are increasingly used to treat several types of cancer. These drugs lead to a wide range of toxicities. Immune-related gastrointestinal adverse events are common and potentially severe. 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