Gastrointestinal complications of immune checkpoint Inhibitor therapy

Immune checkpoint inhibitors (ICI) have improved the prognosis of several cancers. ICI enhance T-cell activation, and therefore stimulate anti-cancer immunity, but also cause immune related adverse effects (irAE), including those affecting the gastrointestinal (GI) tract. GI-irAE are observed in 7 to 30 % of patients treated with ICI. With extending indications of ICI, oncologists, gastroenterologists and primary-care physicians face an increasing number of patients with ICI-induced GI-irAE. This paper summarizes incidence, risk factors, clinical manifestations and management of GI-irAE. Current management of patients with GI IrAE should include refutation of differential diagnoses, assessment of severity, corticosteroids and rapid introduction of infliximab in non-responders.