Abstract
Background
Immune checkpoint inhibitors (ICIs) have improved the outcomes of cancer patients.
However, ICIs often lead to colitis/diarrhea. This study aimed to assess the treatment
of ICIs-associated colitis/diarrhea and outcomes.
Methods
PubMed, EMBASE, and Cochrane Library databases were searched for eligible studies
which investigated the treatment and outcomes of colitis/diarrhea developing in patients
who received ICIs. The pooled incidences of any-grade colitis/diarrhea, low-grade
colitis, high-grade colitis, low-grade diarrhea, and high-grade diarrhea as well as
the pooled rates of response to treatment, mortality, and ICIs permanent discontinuation
and restarts in patients with ICIs-associated colitis/diarrhea were estimated using
a random-effects model.
Results
Among the 11,492 papers initially identified, 27 studies were included. The pooled
incidences of any-grade colitis/diarrhea, low-grade colitis, high-grade colitis, low-grade
diarrhea, and high-grade diarrhea were 17%, 3%, 17%, 13%, and 15%, respectively. The
pooled rates of overall response, response to corticosteroid therapy, and response
to biological agents were 88%, 50%, and 96%, respectively. The pooled short-term mortality
in patients with ICIs-associated colitis/diarrhea was 2%. The pooled incidences of
ICIs permanent discontinuation and restarts were 43% and 33%, respectively.
Conclusion
ICIs-associated colitis/diarrhea is common, but rarely lethal. Half of them are responsive
to corticosteroid therapy. There is a fairly high rate of response to biological agents
in steroid-refractory colitis/diarrhea patients.
Keywords
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Article info
Publication history
Published online: March 07, 2023
Accepted:
February 20,
2023
Received:
January 10,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
