{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T12:43:38Z","timestamp":1785242618922,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T00:00:00Z","timestamp":1694649600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Immune checkpoint inhibitors (ICI) improve the prognosis of many cancers but cause immune\u2010related adverse events (IrAEs). Limited data are available on upper gastrointestinal (UGI) IrAEs. We describe the clinical characteristics, prognosis, and efficacy of medical therapy in patients with UGI IrAEs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective, multicenter cohort study of patients with UGI symptoms and moderate to severe endoscopic UGI lesions, occurring after ICI. Efficacy of induction medical therapy and at the most recent follow\u2010up was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty patients were included; of these, 34 (85%) received anti\u2010PD(L)1, either alone (<jats:italic>n<\/jats:italic>\u00a0=\u00a024) or combined with anti CTLA\u20104 (<jats:italic>n<\/jats:italic>\u00a0=\u00a010). Eighteen patients (45%) had concomitant enterocolitis. All patients had severe endoscopic lesions (erosions, ulcerations, hemorrhage, or necrotic lesions). Three patients who received an inefficient initial medical treatment had a complicated course: One patient died of enterocolitis, one had a pneumomediastinum, and one developed an ulcerated stricture of the pylorus. Thirty\u2010five patients (88%) were treated with corticosteroids; 28 patients (80%) responded, and 20 (57%) reached clinical remission. Eight patients were treated with infliximab, and six responded (75%). After a median follow\u2010up of 11\u00a0months, 36 patients (90%) were in corticosteroid\u2010free clinical remission for their UGI symptoms. Endoscopic lesions persisted in 68% of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ICI cause severe UGI IrAEs, which are associated with enterocolitis in approximately half of the patients. Most patients with UGI IrAEs respond to corticosteroids or infliximab. These data support the recommendation to treat these patients without delay and in the same way as those with enterocolitis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16349","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T03:28:11Z","timestamp":1694748491000},"page":"2104-2110","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Serious immune\u2010related upper gastrointestinal toxicity of immune checkpoint inhibitors: a multicenter case series"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3506-1519","authenticated-orcid":false,"given":"Cl\u00e9ment","family":"Bresteau","sequence":"first","affiliation":[{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris H\u00f4pital Bic\u00eatre  Le Kremlin Bic\u00eatre France"},{"name":"Universit\u00e9 Paris\u2010Saclay  Le Kremlin Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Bonnet","sequence":"additional","affiliation":[{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris, H\u00f4pital Ambroise Par\u00e9, Universit\u00e9 Versailles Saint\u2010Quentin\u2010en\u2010Yvelines  Boulogne\u2010Billancourt France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Robert","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris\u2010Saclay  Le Kremlin Bic\u00eatre France"},{"name":"Institut Gustave Roussy Universit\u00e9 Paris Saclay  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Mussini","sequence":"additional","affiliation":[{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris H\u00f4pital Bic\u00eatre  Le Kremlin Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Saiag","sequence":"additional","affiliation":[{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris, H\u00f4pital Ambroise Par\u00e9, Universit\u00e9 Versailles Saint\u2010Quentin\u2010en\u2010Yvelines  Boulogne\u2010Billancourt France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Buecher","sequence":"additional","affiliation":[{"name":"Institut Curie, PSL Research University, D\u00e9partements de G\u00e9n\u00e9tique et d'Oncologie M\u00e9dicale  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celeste","family":"Lebbe","sequence":"additional","affiliation":[{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris, H\u00f4pital Saint Louis, Universit\u00e9 Paris Cit\u00e9, Dermato\u2010Oncology; INSERM U976  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Allez","sequence":"additional","affiliation":[{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris, H\u00f4pital Saint Louis, Universit\u00e9 Paris Cit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Benamouzig","sequence":"additional","affiliation":[{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris, H\u00f4pital Avicenne, Universit\u00e9 Sorbonne Paris Nord  Bobigny France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herv\u00e9","family":"Hag\u00e8ge","sequence":"additional","affiliation":[{"name":"H\u00f4pital Intercommunal de Cr\u00e9teil, H\u00e9pato\u2010Gastro\u2010Ent\u00e9rologie  Cr\u00e9teil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakim","family":"B\u00e9cheur","sequence":"additional","affiliation":[{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris, H\u00f4pital Bichat\u2010Claude Bernard, Universit\u00e9 Paris Cit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1156-9289","authenticated-orcid":false,"given":"Antoine","family":"Meyer","sequence":"additional","affiliation":[{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris H\u00f4pital Bic\u00eatre  Le Kremlin Bic\u00eatre France"},{"name":"Universit\u00e9 Paris\u2010Saclay  Le Kremlin Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4779-5168","authenticated-orcid":false,"given":"Franck","family":"Carbonnel","sequence":"additional","affiliation":[{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris H\u00f4pital Bic\u00eatre  Le Kremlin Bic\u00eatre France"},{"name":"Universit\u00e9 Paris\u2010Saclay  Le Kremlin Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1910836"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.77.6385"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1712126"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2017699"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx403"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.01.033"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.01547"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12328-021-01582-5"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.14029"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.10.006"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.13963"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2019.1594356"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-017-0300-z"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx225"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjv227"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/esmoopen-2017-000278"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2022.102440"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34543"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.16349","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T05:56:21Z","timestamp":1744264581000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.16349"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,14]]},"references-count":18,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1111\/jgh.16349"],"URL":"https:\/\/doi.org\/10.1111\/jgh.16349","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,14]]},"assertion":[{"value":"2023-06-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}