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Inflammation of the bowel caused by immunotherapy releasing the immune system against the gut lining, producing diarrhoea that can be severe. It is the commonest serious side effect of CTLA-4 antibodies and is treated with steroids and, if needed, infliximab.
Colitis occurs in 10-15% of patients on ipilimumab (higher with nivolumab combination) and 1-3% on PD-1 antibodies alone, typically 6-8 weeks in; grade 3 diarrhoea (≥7 stools/day over baseline) requires holding treatment and high-dose steroids, with infliximab or vedolizumab for refractory cases, and perforation is the feared complication. Faecal microbiota transplantation has reversed refractory colitis in case series, and the gut microbiome influences both colitis risk and response. Chemotherapy and kinase inhibitors (irinotecan, capecitabine, neratinib, abemaciclib, EGFR inhibitors) cause diarrhoea by different mechanisms managed with loperamide and dose adjustment, and diarrhoea is a leading reason for stopping oral targeted drugs.
Backbone ribbon from PDB 5TRU. RCSB PDB 5TRU. The ribbon widens where the chain is folded into a regular pattern and narrows where it is a loose loop.
Showing the molecule this term concerns: Ipilimumab.
Shares Immune-related endocrinopathies (thyroiditis, hypophysitis), Immune-related adverse events (irAEs), Immune checkpoint inhibitors.
Shares Immune-related endocrinopathies (thyroiditis, hypophysitis), Immune-related adverse events (irAEs).
Shares Immune-related adverse events (irAEs), Small-cell lung cancer, Lung cancer (all types), Immune checkpoint inhibitors.
Shares Ipilimumab, Small-cell lung cancer, Immune checkpoint inhibitors, Non-small-cell lung cancer.
Shares Dose reduction, interruption and discontinuation, Immune-related adverse events (irAEs).
Shares Immune-related adverse events (irAEs), Ipilimumab, Immune checkpoint inhibitors.
Shares Immune-related adverse events (irAEs), Ipilimumab, Immune checkpoint inhibitors, Non-small-cell lung cancer.
Shares Irinotecan (and liposomal irinotecan), Small-cell lung cancer, Non-small-cell lung cancer.