Recognition and management of the gastrointestinal and hepatic immune-related adverse events

Abstract

Immunotherapy is revolutionizing the treatment paradigm for a broad spectrum of malignancies. However, the immune checkpoint inhibitors also cause a unique set of toxicities. In the digestive system, this has consisted for the most part as colitis and hepatotoxicity, but also include less-common manifestations. Baseline screening, early identification, timely diagnosis, rapid and adequate treatment can significantly minimize the toxicity of immunotherapy and improve prognosis. This article provides a comprehensive review of gastrointestinal and hepatic immune-related toxicities, including incidence, mechanism, clinical manifestation, diagnosis, treatment, and guidelines for resumption of immune checkpoint inhibitor therapy.