Evidence map›Paper›PMID 41898327›Full record

ReviewBiomedicines2026

Immune-Mediated Colitis Induced by Immune Checkpoint Inhibitors: Pathophysiology, Clinical Management, and the Emerging Role of Fecal Microbiota Transplantation.

Zeljka Belosic Halle, Vedran Tomasic, Alen Biscanin, Petra Cacic, Ivona Saric, Sanda Mustapic, Josip Stojic, Kresimir Luetic, Dinko Bekic, Matej Paic and 10 more

Abstract readReview
In one paragraph

Review in Biomedicines, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Zeljka Belosic HalleDepartment of Gastroenterology and Hepatology, Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia.ORCID 0000-0002-3323-7640
Vedran TomasicSchool of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia.ORCID 0000-0001-8211-3487
Alen BiscaninDepartment of Gastroenterology and Hepatology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia.ORCID 0000-0003-2923-4110
Petra CacicDepartment of Gastroenterology and Hepatology, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia.ORCID 0000-0002-2273-6081
Ivona SaricDepartment of Gastroenterology, University Hospital Merkur, 10000 Zagreb, Croatia.ORCID 0000-0003-0318-4119
Sanda MustapicDepartment of Gastroenterology, Clinical University Hospital Dubrava, 10000 Zagreb, Croatia.
Josip StojicDepartment of Gastroenterology, Clinical University Hospital Dubrava, 10000 Zagreb, Croatia.ORCID 0000-0002-5949-0513
Kresimir LueticDepartment of Gastroenterology and Hepatology, Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia.
Dinko BekicDepartment of Gastroenterology and Hepatology, Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia.ORCID 0000-0002-2941-4472
Matej PaicDepartment of Gastroenterology and Hepatology, Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia.ORCID 0000-0003-2246-3033
Domagoj MiceticDepartment of Gastroenterology, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia.ORCID 0000-0002-1180-8887
Irena Krznaric ZrnicDepartment of Gastroenterology, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia.ORCID 0000-0002-1788-0679
Ivna OlicGastroenterology and Hepatology Department, Internal Medicine, University Hospital of Split, 21000 Split, Croatia.ORCID 0000-0003-3777-7350
Melanija Razov RadasDivision of Gastroenterology, General Hospital Zadar, 23000 Zadar, Croatia.ORCID 0000-0003-4530-4350
Iva SkocilicSchool of Medicine, University of Rijeka, 51000 Rijeka, Croatia.
Marin GolčicSchool of Medicine, University of Rijeka, 51000 Rijeka, Croatia.ORCID 0000-0002-3388-4813
Laura RadosDepartment for Emergency Medicine of Primorsko-Goranska County, 51000 Rijeka, Croatia.
Jasna RadicSchool of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
Juraj PrejacDepartment of Oncology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia.ORCID 0000-0003-1981-9369
Ivana MikolasevicDepartment of Gastroenterology, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesImmune checkpoint inhibitors (ICIs) have revolutionized the treatment of various malignancies, but their use is frequently accompanied by immune-related adverse events, among which immune-mediated colitis (IMC) represents one of the most common and clinically significant gastrointestinal toxicities. IMC may lead to treatment interruption, increased morbidity, and compromised quality of life. This review aims to provide a comprehensive overview of the pathophysiology, risk factors, diagnosis, management, and emerging therapeutic strategies with particular emphasis on the role of the gut microbiota and fecal microbiota transplantation (FMT).

methodsThis review integrates current international guidelines, meta-analyses, clinical trials, and recent translational studies addressing IMC. The available evidence on immunological mechanisms, predictive biomarkers, clinical presentation, diagnostic algorithms, and treatment options was critically synthesized to outline a structured and multidisciplinary management approach.

resultsIMC is driven by dysregulated immune activation, cytokine release, and alterations in gut microbiota. Incidence and severity vary according to ICI class, combination regimens, tumor type, and patient-related factors. Diagnosis requires exclusion of infectious causes, laboratory assessment, and endoscopic and histologic evaluation with CTCAE-based severity grading. Corticosteroids remain the cornerstone of first-line therapy, while infliximab and vedolizumab are effective in steroid-refractory cases. Emerging therapies, including JAK inhibitors and FMT, have shown promising results in refractory disease.

conclusionsIMC is a complex and potentially severe complication of ICI therapy that necessitates early recognition, accurate grading, and individualized, multidisciplinary management. Severity-guided treatment, timely escalation to biologics, and careful balancing of immunosuppression with antitumor efficacy are essential for optimal outcomes. Future research should focus on biomarker validation, microbiome-targeted therapies, and prospective trials to refine therapeutic algorithms and define the optimal role and timing of FMT in clinical practice.

Indexed as

cancercolitisfecal microbiota transplantationimmune checkpoint inhibitorsimmune-mediated colitisimmune-related adverse eventsimmunotherapymanagementmicrobiota

Identifiers

PMID41898327
PMCPMC13024531

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.