Checkpoint Inhibitor-Induced Colitis-A Clinical Overview of Incidence, Prognostic Implications and Extension of Current Treatment Options

In recent years, anti-tumor immunotherapies have witnessed a major breakthrough with the emergence of immune checkpoint inhibitors (ICIs). However, the use of ICIs has also brought an era of a certain class of adverse events that differ from those of classical chemotherapies and are more reminiscent of autoimmune diseases. This article focuses exclusively on colitis as an irAE with emphasis on vulnerable patient groups, the prognostic significance of colitis, treatment, and new therapeutic approaches that may be applicable. Colitis itself is associated with a favorable oncological outcome of the underlying disease but is as well the most common irAE leading to discontinuation of therapy. Especially in vulnerable patient groups such as IBD patients and elderly patients, colitis occurs more frequently as a side effect. It is precisely in these two patient groups that side effects more often lead to discontinuation of therapy. Therefore, in addition to the current therapy of colitis through immunosuppression, the focus should also be on new forms of therapy of severe colitis, such as fecal transplantation or ileostomy creation.

Automated summary

In recent years, anti-tumor immunotherapies, specifically immune checkpoint inhibitors (ICIs), have shown significant progress. However, ICIs have also introduced a new class of adverse events, such as colitis, which are more common in vulnerable patient groups like IBD patients and the elderly. Colitis, while associated with a favorable oncological outcome, is also the most common irAE leading to discontinuation of therapy, particularly in these vulnerable groups. New therapeutic approaches, such as fecal transplantation or ileostomy creation, may offer promising alternatives for severe cases of colitis.