Table 1. Summary of Reported IrAEs Involving Gastrointestinal System: UDCA, ENBD.
References | Presentation | Number of cases | Age (mean) | Immune checkpoint inhibitors (number of cases) | Doses (mean) | Treatment (outcome) |
---|---|---|---|---|---|---|
Tubular gastrointestinal tract | ||||||
[14-27] | Enterocolitis/enteritis/colitis | 14 | 32 - 85 (65) | Pembrolizumab-3, nivolumab-11 | 1 - 19 (13) | Prednisone/infliximab/mesalazine/budesonide, improved |
[28, 29] | Intestinal perforation | 2 | 73, 65 | Nivolumab-2 | 3, 3 | Surgical intervention, improved |
[30] | Intestinal pseudo-obstruction | 1 | 62 | Nivolumab | 14 | Prednisone, improved |
[31] | Esophagitis and gastritis | 1 | 93 | Nivolumab | 6 mo. | Prednisone, improved |
[32] | Hemorrhagic gastritis | 1 | 77 | Nivolumab | 10 | Prednisolone, improved |
[33] | Oral mucositis, esophagitis | 1 | 69 | Pembrolizumab | 14 | Methylprednisolone, prednisone, improved |
[34] | Intra-abdominal abscess | 1 | 49 | Pembrolizumab | 5 | Abscess drainage, antibiotics, adalimumab, improved |
Liver | ||||||
[35-42] | Hepatitis | 11 | 42 - 80 (61) | Pembrolizumab-5, nivolumab-6 | 1 - 17 (5) | Methylprednisolone/corticosteroids/prednisone/UDCA/mycophenolate, improved |
[40] | Vanishing bile duct syndrome | 1 | 49 | Pembrolizumab | 1 | Prednisolone, UDCA, mycophenolate |
[43] | Acute liver failure | 1 | 60 | Pembrolizumab | 1 | Prednisone/deceased |
Biliary tract | ||||||
[44-46] | Cholangitis | 5 | 64 - 82 (75) | Nivolumab-5 | 4 - 12 (8) | Methylprednisolone/UDCA/stent/prednisone, improved |
[47] | Cholecystitis | 1 | 63 | Nivolumab | 5 | stent, ENBD, antibiotics, steroids |
Pancreas | ||||||
[48-52] | Pancreatitis | 6 | 43 - 76 (57) | Pembrolizumab-2, nivolumab-4 | 2 - 19 (7) | Prednisone/duodenal stent/pancreaticoduodectomy/pancreatic enzymes/dexamethasone, improved |
UDCA: ursodeoxycholic acid; ENBD: endoscopic naso-biliary drainage.