Immune mediated colitis: a surgical perspective

Abstract

Background: This study aims to review and summarize the current up to date literature that explore the current treatment approaches to immune mediated colitis and the role of surgical specialties in the landscape of management.

Methods: A narrative review of papers was performed following a literature search through Medline, EMBASE and Cochrane Central databases pertaining to immune mediated colitis as an adverse event of cancer immunotherapy.

Results: Current guidelines for the diagnosis and treatment of immune mediated colitis mirror the approach to the workup of inflammatory bowel disease and guided by treating oncology and gastroenterology specialties. Immune mediated colitis however relies on surgical specific skills as a consequence of obtaining a diagnosis as well as in the management of complications that may arise.

Conclusion: Immune mediate colitis management has largely been under the purview of medical specialties. This review explores the current landscape of managing immune mediated colitis from a surgical perspective and highlights key areas in which surgeons can engage in the multidisciplinary care of this condition. To facilitate prompt diagnosis and management of immune-mediated colitis, there is an increasing necessity for surgeons to become familiar with the latest multidisciplinary approaches and recommendations.

Keywords: checkpoint inhibitor induced colitis; checkpoint inhibitors; colon; cytotoxic T-lymphocyte associated antigen 4; immune checkpoint inhibitors; immune mediated colitis; immune related adverse events; immune therapy; immunotherapy; immunotherapy induced colitis; programmed cell death protein 1; programmed death ligand 1.