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RESOURCE TYPE: Expert opinion

Unable to discern any information about scope or evidence used in this article. Expert opinion.

Recommendations for the management of low-grade diarrhea include symptomatic treatment with hydration (oral) and electrolyte replacement. Prednisone 1 mg/kg can be used as necessary followed by a four-week taper. For high-grade diarrhea, patients should be treated with high-dose IV steroids (methylprednisolone 2 mg/kg) one or two times per day, which should be tapered for improvement of symptoms over four weeks, and IV hydration with electrolyte replacement. For symptoms that improve after five to seven days, or for relapse after steroid taper, infliximab 5 mg/kg once every two weeks is suggested as an alternative immunotherapy.

Limited clinical experience with managing irAEs exists because of immune checkpoint inhibitors therapy and because only patients with non-small cell lung cancer were considered.

Additional studies need to be conducted to determine the best management practice for gastrointestinal side-effect management with immune-checkpoint blocking antibodies across a variety of cancer types.