The growing potential of tofacitinib in immune checkpoint inhibitor-induced colitis: identifying remaining puzzle pieces
Immunotherapy, a primary anti-neoplastic treatment, exploits the patient’s immune system to kill neoplastic cells by modulating immune checkpoints such as cytotoxic T-lymphocyte antigen 4 and programmed cell death 1. Despite an apparent anti-neoplastic efficacy, immunotherapeutic agents are often ac...
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| Language: | English |
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Open Exploration Publishing Inc.
2024-11-01
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| Series: | Exploration of Immunology |
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| Online Access: | https://www.explorationpub.com/Journals/ei/Article/1003171 |
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| author | Raffaele Pellegrino Giovanna Palladino Giuseppe Imperio Antonietta Gerarda Gravina |
| author_facet | Raffaele Pellegrino Giovanna Palladino Giuseppe Imperio Antonietta Gerarda Gravina |
| author_sort | Raffaele Pellegrino |
| collection | DOAJ |
| description | Immunotherapy, a primary anti-neoplastic treatment, exploits the patient’s immune system to kill neoplastic cells by modulating immune checkpoints such as cytotoxic T-lymphocyte antigen 4 and programmed cell death 1. Despite an apparent anti-neoplastic efficacy, immunotherapeutic agents are often accompanied by multiorgan toxicity, including gastrointestinal ones. This particular class of immunotherapy-related adverse events, mainly represented by diarrhea and colitis, necessitates a nuanced treatment strategy. Current treatments are primarily based on standardized severity grading systems to guide and proportion therapeutic interventions, ranging from simple behavioral modifications or conventional molecules (such as anti-diarrheal) to advanced biological treatments. Tofacitinib, a pan-Janus kinase inhibitor, emerged as a potential option for managing immune-related (IR) colitis by targeting hyperactivated T cells within the colic microenvironment. However, evidence supporting the use of tofacitinib in IR colitis is primarily derived from case reports and small case series, lacking robust randomized clinical trial data. While preliminary findings demonstrate encouraging clinical control of IR colitis with tofacitinib, further research is warranted to elucidate its efficacy, safety, optimal dosage, and treatment duration. Although there are some worries about its effects on cancer response and safety, current evidence indicates that tofacitinib could be seen as a possible treatment choice if other therapies with more robust evidence profiles have not been successful. |
| format | Article |
| id | doaj-art-eea866b22cdc4e7a883c8c62b3b5ef24 |
| institution | OA Journals |
| issn | 2768-6655 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Open Exploration Publishing Inc. |
| record_format | Article |
| series | Exploration of Immunology |
| spelling | doaj-art-eea866b22cdc4e7a883c8c62b3b5ef242025-08-20T02:32:42ZengOpen Exploration Publishing Inc.Exploration of Immunology2768-66552024-11-014677077910.37349/ei.2024.00171The growing potential of tofacitinib in immune checkpoint inhibitor-induced colitis: identifying remaining puzzle piecesRaffaele Pellegrino0https://orcid.org/0000-0001-5074-230XGiovanna Palladino1https://orcid.org/0000-0002-7367-4175Giuseppe Imperio2https://orcid.org/0000-0002-4182-2858Antonietta Gerarda Gravina3https://orcid.org/0000-0001-8049-0115Hepatogastroenterology Division, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples 80138, ItalyHepatogastroenterology Division, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples 80138, ItalyHepatogastroenterology Division, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples 80138, ItalyHepatogastroenterology Division, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples 80138, ItalyImmunotherapy, a primary anti-neoplastic treatment, exploits the patient’s immune system to kill neoplastic cells by modulating immune checkpoints such as cytotoxic T-lymphocyte antigen 4 and programmed cell death 1. Despite an apparent anti-neoplastic efficacy, immunotherapeutic agents are often accompanied by multiorgan toxicity, including gastrointestinal ones. This particular class of immunotherapy-related adverse events, mainly represented by diarrhea and colitis, necessitates a nuanced treatment strategy. Current treatments are primarily based on standardized severity grading systems to guide and proportion therapeutic interventions, ranging from simple behavioral modifications or conventional molecules (such as anti-diarrheal) to advanced biological treatments. Tofacitinib, a pan-Janus kinase inhibitor, emerged as a potential option for managing immune-related (IR) colitis by targeting hyperactivated T cells within the colic microenvironment. However, evidence supporting the use of tofacitinib in IR colitis is primarily derived from case reports and small case series, lacking robust randomized clinical trial data. While preliminary findings demonstrate encouraging clinical control of IR colitis with tofacitinib, further research is warranted to elucidate its efficacy, safety, optimal dosage, and treatment duration. Although there are some worries about its effects on cancer response and safety, current evidence indicates that tofacitinib could be seen as a possible treatment choice if other therapies with more robust evidence profiles have not been successful.https://www.explorationpub.com/Journals/ei/Article/1003171immune checkpoint inhibitorscolitisimmunotherapytofacitinib |
| spellingShingle | Raffaele Pellegrino Giovanna Palladino Giuseppe Imperio Antonietta Gerarda Gravina The growing potential of tofacitinib in immune checkpoint inhibitor-induced colitis: identifying remaining puzzle pieces Exploration of Immunology immune checkpoint inhibitors colitis immunotherapy tofacitinib |
| title | The growing potential of tofacitinib in immune checkpoint inhibitor-induced colitis: identifying remaining puzzle pieces |
| title_full | The growing potential of tofacitinib in immune checkpoint inhibitor-induced colitis: identifying remaining puzzle pieces |
| title_fullStr | The growing potential of tofacitinib in immune checkpoint inhibitor-induced colitis: identifying remaining puzzle pieces |
| title_full_unstemmed | The growing potential of tofacitinib in immune checkpoint inhibitor-induced colitis: identifying remaining puzzle pieces |
| title_short | The growing potential of tofacitinib in immune checkpoint inhibitor-induced colitis: identifying remaining puzzle pieces |
| title_sort | growing potential of tofacitinib in immune checkpoint inhibitor induced colitis identifying remaining puzzle pieces |
| topic | immune checkpoint inhibitors colitis immunotherapy tofacitinib |
| url | https://www.explorationpub.com/Journals/ei/Article/1003171 |
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