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Clinic, Endoscopic and Histological Features in Patients Treated with ICI Developing GI Toxicity: Some News and Reappraisal from a Mono-Institutional Experience
Background: Immune checkpoint inhibitors (ICIs) have widened the therapeutic scenario of different solid tumors over the last ten years. Gastrointestinal (GI) adverse events (AEs), such as diarrhea and colitis, occur in up to 50% of patients treated with ICIs. Materials and methods: We conducted a s...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947154/ https://www.ncbi.nlm.nih.gov/pubmed/35328239 http://dx.doi.org/10.3390/diagnostics12030685 |
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author | Parente, Paola Maiorano, Brigida Anna Ciardiello, Davide Cocomazzi, Francesco Carparelli, Sonia Guerra, Maria Ingravallo, Giuseppe Cazzato, Gerardo Carosi, Illuminato Maiello, Evaristo Bossa, Fabrizio |
author_facet | Parente, Paola Maiorano, Brigida Anna Ciardiello, Davide Cocomazzi, Francesco Carparelli, Sonia Guerra, Maria Ingravallo, Giuseppe Cazzato, Gerardo Carosi, Illuminato Maiello, Evaristo Bossa, Fabrizio |
author_sort | Parente, Paola |
collection | PubMed |
description | Background: Immune checkpoint inhibitors (ICIs) have widened the therapeutic scenario of different solid tumors over the last ten years. Gastrointestinal (GI) adverse events (AEs), such as diarrhea and colitis, occur in up to 50% of patients treated with ICIs. Materials and methods: We conducted a single-center retrospective analysis in patients with solid tumors treated with ICIs in a 6-year period, from 2015 to 2021, developing GI AEs, for which an endoscopic analysis was performed, with available histological specimens or surgery. Results: Twenty-one patients developed GI AEs under ICIs. The median time from the start of ICIs to the onset of GI AEs was 5 months. Diarrhea was the most frequent symptom (57.2%), upper GI symptoms presented in four patients (19%), while three patients (14.3%) had no symptoms and were diagnosed occasionally. Two patients underwent surgical resection for acute abdomen. Histological findings observed in endoscopic sampling were eosinophilic-pattern gastro-enterocolitis, apoptotic damage, IBD-like features, and ischemic-like changes. Histological damage was also documented in patients with unremarkable endoscopy. Conclusions: Under ICI therapy, GI toxicity is an expected event. Since GIAEs can mimic a broad range of primary GI diseases, a multidisciplinary approach is advocated with upper and lower GI mucosal sampling to remodel therapy and avoid complications. |
format | Online Article Text |
id | pubmed-8947154 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-89471542022-03-25 Clinic, Endoscopic and Histological Features in Patients Treated with ICI Developing GI Toxicity: Some News and Reappraisal from a Mono-Institutional Experience Parente, Paola Maiorano, Brigida Anna Ciardiello, Davide Cocomazzi, Francesco Carparelli, Sonia Guerra, Maria Ingravallo, Giuseppe Cazzato, Gerardo Carosi, Illuminato Maiello, Evaristo Bossa, Fabrizio Diagnostics (Basel) Article Background: Immune checkpoint inhibitors (ICIs) have widened the therapeutic scenario of different solid tumors over the last ten years. Gastrointestinal (GI) adverse events (AEs), such as diarrhea and colitis, occur in up to 50% of patients treated with ICIs. Materials and methods: We conducted a single-center retrospective analysis in patients with solid tumors treated with ICIs in a 6-year period, from 2015 to 2021, developing GI AEs, for which an endoscopic analysis was performed, with available histological specimens or surgery. Results: Twenty-one patients developed GI AEs under ICIs. The median time from the start of ICIs to the onset of GI AEs was 5 months. Diarrhea was the most frequent symptom (57.2%), upper GI symptoms presented in four patients (19%), while three patients (14.3%) had no symptoms and were diagnosed occasionally. Two patients underwent surgical resection for acute abdomen. Histological findings observed in endoscopic sampling were eosinophilic-pattern gastro-enterocolitis, apoptotic damage, IBD-like features, and ischemic-like changes. Histological damage was also documented in patients with unremarkable endoscopy. Conclusions: Under ICI therapy, GI toxicity is an expected event. Since GIAEs can mimic a broad range of primary GI diseases, a multidisciplinary approach is advocated with upper and lower GI mucosal sampling to remodel therapy and avoid complications. MDPI 2022-03-11 /pmc/articles/PMC8947154/ /pubmed/35328239 http://dx.doi.org/10.3390/diagnostics12030685 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Parente, Paola Maiorano, Brigida Anna Ciardiello, Davide Cocomazzi, Francesco Carparelli, Sonia Guerra, Maria Ingravallo, Giuseppe Cazzato, Gerardo Carosi, Illuminato Maiello, Evaristo Bossa, Fabrizio Clinic, Endoscopic and Histological Features in Patients Treated with ICI Developing GI Toxicity: Some News and Reappraisal from a Mono-Institutional Experience |
title | Clinic, Endoscopic and Histological Features in Patients Treated with ICI Developing GI Toxicity: Some News and Reappraisal from a Mono-Institutional Experience |
title_full | Clinic, Endoscopic and Histological Features in Patients Treated with ICI Developing GI Toxicity: Some News and Reappraisal from a Mono-Institutional Experience |
title_fullStr | Clinic, Endoscopic and Histological Features in Patients Treated with ICI Developing GI Toxicity: Some News and Reappraisal from a Mono-Institutional Experience |
title_full_unstemmed | Clinic, Endoscopic and Histological Features in Patients Treated with ICI Developing GI Toxicity: Some News and Reappraisal from a Mono-Institutional Experience |
title_short | Clinic, Endoscopic and Histological Features in Patients Treated with ICI Developing GI Toxicity: Some News and Reappraisal from a Mono-Institutional Experience |
title_sort | clinic, endoscopic and histological features in patients treated with ici developing gi toxicity: some news and reappraisal from a mono-institutional experience |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947154/ https://www.ncbi.nlm.nih.gov/pubmed/35328239 http://dx.doi.org/10.3390/diagnostics12030685 |
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