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  1. Article ; Online: Continuing Medical Education Questions: March 2023.

    Grover, Shilpa

    The American journal of gastroenterology

    2022  Volume 118, Issue 3, Page(s) 404

    Abstract: Article Title: Fecal Microbiota Transplantation Across the Lifespan- Balancing Efficacy, Safety, and Innovation. ...

    Abstract Article Title: Fecal Microbiota Transplantation Across the Lifespan- Balancing Efficacy, Safety, and Innovation.
    MeSH term(s) Humans ; Education, Medical, Continuing ; Fecal Microbiota Transplantation
    Language English
    Publishing date 2022-12-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 390122-1
    ISSN 1572-0241 ; 0002-9270
    ISSN (online) 1572-0241
    ISSN 0002-9270
    DOI 10.14309/ajg.0000000000002199
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Review article: Contemporary management of gastrointestinal, pancreatic and hepatic toxicities of immune checkpoint inhibitors.

    Townsend, Matthew J / Benque, Isaac J / Li, Michael / Grover, Shilpa

    Alimentary pharmacology & therapeutics

    2024  

    Abstract: Background: Immune checkpoint inhibitors (ICIs) are effective oncologic agents which frequently cause immune-related adverse events (irAEs) which can impact multiple organ systems. Onco-Gastroenterology is a novel and emerging subspecialty within ... ...

    Abstract Background: Immune checkpoint inhibitors (ICIs) are effective oncologic agents which frequently cause immune-related adverse events (irAEs) which can impact multiple organ systems. Onco-Gastroenterology is a novel and emerging subspecialty within gastroenterology focused on cancer treatment-related complications. Gastroenterologists must be prepared to identify and manage diverse immune-mediated toxicities including enterocolitis, hepatitis, pancreatitis and other ICI-induced toxicities.
    Aim: To provide a narrative review of the epidemiology, diagnostic evaluation and management of checkpoint inhibitor-induced gastrointestinal and hepatic toxicities.
    Methods: We searched Cochrane and PubMed databases for articles published through August 2023.
    Results: Gastrointestinal and hepatic irAEs include most commonly enterocolitis and hepatitis, but also pancreatitis, oesophagitis, gastritis, motility disorders (gastroparesis) and other rarer toxicities. Guidelines from the National Comprehensive Cancer Network, American Society of Clinical Oncology and European Society for Medical Oncology, in combination with emerging cohort and clinical trial data, offer strategies for management of ICI toxicities. Evaluation of irAEs severity by formal classification and clinical stability, and a thorough workup for alternative etiologies which may clinically mimic irAEs underlie initial management. Treatments include corticosteroids, biologics and other immunosuppressive agents plus supportive care; decisions on dosing, timing and choice of steroid adjuncts and potential for subsequent checkpoint inhibitor dosing are nuanced and toxicity-specific.
    Conclusions: Expanding clinical trial and cohort data have clarified the epidemiology and clinical characteristics of gastrointestinal, pancreatic and hepatic toxicities of ICIs. Guidelines, though valuable, remain based principally on retrospective cohort data. Quality prospective, controlled studies may refine algorithms for treatment and potential immunotherapy rechallenge.
    Language English
    Publishing date 2024-04-08
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 639012-2
    ISSN 1365-2036 ; 0269-2813 ; 0953-0673
    ISSN (online) 1365-2036
    ISSN 0269-2813 ; 0953-0673
    DOI 10.1111/apt.17980
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Infliximab for Steroid-Refractory Immune Checkpoint Inhibitor-Induced Acute Pancreatitis.

    Townsend, Matthew J / Hodi, F Stephen / Grover, Shilpa

    ACG case reports journal

    2023  Volume 10, Issue 3, Page(s) e01018

    Abstract: Acute pancreatitis is an infrequent but clinically significant complication of immune checkpoint inhibitor (ICI) therapy. Guidelines recommend high-dose steroids and withdrawal of ICI in patients with severe ICI-induced pancreatitis. Management of ... ...

    Abstract Acute pancreatitis is an infrequent but clinically significant complication of immune checkpoint inhibitor (ICI) therapy. Guidelines recommend high-dose steroids and withdrawal of ICI in patients with severe ICI-induced pancreatitis. Management of steroid-refractory ICI pancreatitis is unclear. Infliximab is used to treat select extrapancreatic immune-related adverse events, but its role in ICI pancreatitis remains undefined. To our knowledge, we describe the first case of ICI pancreatitis successfully treated with infliximab after inadequate steroid response (recurrent pancreatitis on multiple attempted steroid tapers). Infliximab may be a viable treatment of steroid-refractory ICI pancreatitis. Further study of its potential effectiveness may improve guideline-directed care.
    Language English
    Publishing date 2023-03-24
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2814825-3
    ISSN 2326-3253
    ISSN 2326-3253
    DOI 10.14309/crj.0000000000001018
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  4. Article ; Online: Prognostic Value of Inflammatory Bowel Disease-associated Biomarkers in Patients With Immune Checkpoint Inhibitor Enterocolitis: A Retrospective Cohort Study.

    Kogan, Lawrence / Townsend, Matthew J / Raj, Dhanya / Levy, Alexander N / Giobbie-Hurder, Anita / Grover, Shilpa

    Inflammatory bowel diseases

    2023  

    Language English
    Publishing date 2023-07-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 1340971-2
    ISSN 1536-4844 ; 1078-0998
    ISSN (online) 1536-4844
    ISSN 1078-0998
    DOI 10.1093/ibd/izad121
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    Zs.A 4530: Show issues Location:
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  5. Article ; Online: Lymphocytic colitis-like pattern of mucosal injury and the challenges in diagnosing cancer immunotherapy-related toxicity.

    Grover, Shilpa / Srivastava, Amitabh

    Cancer

    2019  Volume 125, Issue 11, Page(s) 1768–1770

    MeSH term(s) Antineoplastic Agents, Immunological/adverse effects ; Colitis, Lymphocytic/chemically induced ; Colitis, Lymphocytic/diagnosis ; Female ; Humans ; Immunotherapy/adverse effects ; Melanoma/drug therapy ; Melanoma/immunology ; Melanoma/secondary ; Middle Aged ; Mucous Membrane/drug effects ; Mucous Membrane/injuries ; Mucous Membrane/pathology ; Prognosis
    Chemical Substances Antineoplastic Agents, Immunological
    Language English
    Publishing date 2019-03-20
    Publishing country United States
    Document type Case Reports
    ZDB-ID 1429-1
    ISSN 1097-0142 ; 0008-543X ; 1934-662X
    ISSN (online) 1097-0142
    ISSN 0008-543X ; 1934-662X
    DOI 10.1002/cncr.32005
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  6. Article ; Online: Commentary: Dengue hemorrhagic fever: Panophthalmitis or sterile sclerocorneal melt?

    Grover, Ashok Kumar / Bageja, Shaloo / Mittal, Shilpa Taneja

    Indian journal of ophthalmology

    2019  Volume 67, Issue 10, Page(s) 1777–1778

    MeSH term(s) Cornea ; Corneal Diseases ; Humans ; Panophthalmitis ; Severe Dengue
    Language English
    Publishing date 2019-09-20
    Publishing country India
    Document type Journal Article ; Comment
    ZDB-ID 187392-1
    ISSN 1998-3689 ; 0301-4738
    ISSN (online) 1998-3689
    ISSN 0301-4738
    DOI 10.4103/ijo.IJO_1268_19
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    Zs.B 329: Show issues Location:
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    Zs.MO 598: Show issues

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  7. Article ; Online: Correction to: Gastroparesis Following Immune Checkpoint Inhibitor Therapy: A Case Series.

    Atieh, Jessica / Sack, Jordan / Thomas, Richard / Rahma, Osama E / Camilleri, Michael / Grover, Shilpa

    Digestive diseases and sciences

    2020  Volume 66, Issue 8, Page(s) 2843–2844

    Language English
    Publishing date 2020-08-06
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-020-06515-9
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  8. Article ; Online: Outcomes of High-Grade Immune Checkpoint Inhibitor Hepatitis in Hospitalized and Nonhospitalized Patients.

    Li, Michael / Wong, Danny / Sack, Jordan S / Vogel, Alexander S / Hodi, F Stephen / Fong, Lawrence / Lai, Jennifer C / Zucker, Stephen D / Grover, Shilpa

    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

    2024  

    Abstract: Background & aims: Guidelines recommend hospitalization for severe immune checkpoint inhibitor (ICI) hepatitis. We compared patient outcomes in the inpatient versus outpatient settings.: Methods: We conducted a multicenter, retrospective cohort study ...

    Abstract Background & aims: Guidelines recommend hospitalization for severe immune checkpoint inhibitor (ICI) hepatitis. We compared patient outcomes in the inpatient versus outpatient settings.
    Methods: We conducted a multicenter, retrospective cohort study of 294 ICI-treated patients who developed grade 3-4 ICI hepatitis. The primary outcome was time to alanine aminotransferase (ALT) normalization (≤40); secondary outcomes included time to ALT ≤100 U/L and time to death. To account for confounding by indication, inverse probability of treatment weighting was applied to perform Cox regression. A sensitivity analysis was performed excluding patients with grade 4 hepatitis.
    Results: One hundred and sixty-six patients (56.5%) were hospitalized for a median of 6 (interquartile range, 3-11) days. On inverse probability of treatment weighting Cox regression, hospitalization was not associated with time to ALT normalization (hazard ratio [HR], 1.11; 95% confidence interval [CI], 0.86-1.43; P = .436) or time to ALT ≤100 U/L (HR, 1.11; 95% CI, 0.86-1.43; P = .420). In the sensitivity analysis limited to patients with grade 3 hepatitis, hospitalization was also not associated with time to ALT normalization (HR, 1.11; 95% CI, 0.83-1.50; P = .474) or time to ALT ≤100 U/L (HR, 1.19; 95% CI, 0.90-1.58; P = .225). In a subgroup analysis of 152 patients with melanoma, hospitalization was not associated with reduced risk of all-cause death (HR, 0.93; 95% CI, 0.53-1.64; P = .798). Notably, despite their Common Terminology Criteria for Adverse Events classification of high-grade hepatitis, 94% of patients had "mild" liver injury based on International Drug-Induced Liver Injury Criteria.
    Conclusions: Hospitalization of patients with high-grade ICI hepatitis was not associated with faster hepatitis resolution and did not affect mortality. Routine hospitalization may not be necessary in all patients with high-grade ICI hepatitis and Common Terminology Criteria for Adverse Events criteria may overestimate severity of liver injury.
    Language English
    Publishing date 2024-02-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2119789-1
    ISSN 1542-7714 ; 1542-3565
    ISSN (online) 1542-7714
    ISSN 1542-3565
    DOI 10.1016/j.cgh.2024.02.006
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    Zs.A 5836: Show issues Location:
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  9. Article ; Online: Management of immunotherapy colitis: Special considerations in the COVID-19 era.

    Grover, Shilpa / Bond, Sheila A / Mansour, Michael K / Friedman, Sonia

    Cancer

    2020  Volume 126, Issue 21, Page(s) 4630–4633

    MeSH term(s) Antibodies, Monoclonal, Humanized/adverse effects ; Antibodies, Monoclonal, Humanized/therapeutic use ; Antineoplastic Agents, Immunological/adverse effects ; Antiviral Agents/therapeutic use ; COVID-19/diagnosis ; COVID-19/drug therapy ; COVID-19/etiology ; Carcinoma, Non-Small-Cell Lung/therapy ; Colitis/chemically induced ; Colitis/diagnostic imaging ; Colitis/drug therapy ; Diarrhea/chemically induced ; Diarrhea/virology ; Feces/chemistry ; Female ; Glucocorticoids/therapeutic use ; Humans ; Immunotherapy/adverse effects ; Leukocyte L1 Antigen Complex/analysis ; Lung Neoplasms/therapy ; Middle Aged
    Chemical Substances Antibodies, Monoclonal, Humanized ; Antineoplastic Agents, Immunological ; Antiviral Agents ; Glucocorticoids ; Leukocyte L1 Antigen Complex ; pembrolizumab (DPT0O3T46P) ; tocilizumab (I031V2H011)
    Keywords covid19
    Language English
    Publishing date 2020-08-14
    Publishing country United States
    Document type Case Reports
    ZDB-ID 1429-1
    ISSN 1097-0142 ; 0008-543X ; 1934-662X
    ISSN (online) 1097-0142
    ISSN 0008-543X ; 1934-662X
    DOI 10.1002/cncr.33125
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