Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2024; 30(14): 1941-1948
Published online Apr 14, 2024. doi: 10.3748/wjg.v30.i14.1941
Immune checkpoint inhibitor-associated gastritis: Patterns and management
Jing Lin, Zhong-Qiao Lin, Shi-Cheng Zheng, Yu Chen
Jing Lin, Yu Chen, Department of Medical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350000, Fujian Province, China
Zhong-Qiao Lin, Phase I Clinical Trial Ward, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350000, Fujian Province, China
Shi-Cheng Zheng, School of Basic Medical Sciences, Fujian Medical University, Fuzhou 350000, Fujian Province, China
Co-first authors: Jing Lin and Zhong-Qiao Lin.
Author contributions: Lin J and Lin ZQ contributed equally to this work; Lin J designed the study and revised the manuscript; Lin ZQ performed the research and wrote the manuscript; Zheng SC wrote the manuscript and contributed on funding; Chen Y revised and supervised the manuscript, and contributed on funding; All authors have read and approve the final manuscript.
Supported by Joint Funds for the Innovation of Science and Technology, Fujian Province, China, No. 2021Y9227; Natural Science Foundation of Fujian Province, China, No. 2023J011254; The Science Foundation for The Excellent Youth Scholars of Fujian Provincial Health Commission, China, No. 2022ZQNZD009; The Special Research Funds for Local Science and Technology Development Guided by Central Government, Fujian Province, China, No. 2023L3020; and Fujian Medical University Student Innovation and Entrepreneurship Training Project, China, No. JC2023191.
Conflict-of-interest statement: All authors have no conflicts of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu Chen, MD, Chief Doctor, Department of Medical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420 Fumu Road, Jin’an District, Fuzhou 350000, Fujian Province, China. chenyu1980@fjmu.edu.cn
Received: December 15, 2023
Peer-review started: December 15, 2023
First decision: February 19, 2024
Revised: February 23, 2024
Accepted: March 28, 2024
Article in press: March 28, 2024
Published online: April 14, 2024

Immune checkpoint inhibitors (ICIs) are widely used due to their effectiveness in treating various tumors. Immune-related adverse events (irAEs) are defined as adverse effects resulting from ICI treatment. Gastrointestinal irAEs are a common type of irAEs characterized by intestinal side effects, such as diarrhea and colitis, which may lead to the cessation of ICIs. Although irAE gastritis is rarely reported, it may lead to serious complications such as gastrorrhagia. Furthermore, irAE gastritis is often difficult to identify early due to its diverse symptoms. Although steroid hormones and immunosuppressants are commonly used to reverse irAEs, the best regimen and dosage for irAE gastritis remains uncertain. In addition, the risk of recurrence of irAE gastritis after the reuse of ICIs should be considered. In this editorial, strategies such as early identification, pathological diagnosis, management interventions, and immunotherapy rechallenge are discussed to enable clinicians to better manage irAE gastritis and improve the prognosis of these patients.

Keywords: Immunotherapy, Immune checkpoint inhibitor, Immune-related adverse events, Immune checkpoint inhibitor-related gastritis

Core Tip: Immune checkpoint inhibitor (ICI)-related gastritis is rare but may lead to serious complications such as gastrorrhagia. Biopsy under esophagogastroduodenoscopy is the gold standard for diagnosis. Specifically, this article discusses strategies for treating ICI-related gastritis, including early recognition, pathological diagnosis, management interventions, and rechallenge with immunotherapy, providing clinicians with valuable consultations to enable cancer patients to benefit early from treatment.