Portal de Periódicos da CAPES

A 1-year follow-up study on checkpoint inhibitor-induced colitis: results from a European consortium

2024; Elsevier BV; Volume: 9; Issue: 7 Linguagem: Inglês

10.1016/j.esmoop.2024.103632

2059-7029

Marco Vincenzo Lenti, D.G. Ribaldone, F. Borrelli De Andreis, M. Vernero, Brigida Barberio, M. De Ruvo, E.V. Savarino, Taylan Kav, Andreas Blesl, Maria Alice Franzoi, H Gröchenig, D. Pugliese, Gianluca Ianiro, S. Porcari, Giovanni Cammarota, Antonio Gasbarrini, Rocco Spagnuolo, Pierre Ellul, Kalliopi Foteinogiannopoulou, Ioannis E. Κoutroubakis, Konstantinos Argyriou, M. Cappello, Aranzazu Jauregui-Amezaga, M.G. Demarzo, Nicola Silvestris, A. Armuzzi, F. Sottotetti, Lorenzo Bertani, Stefano Festa, Piotr Eder, Paolo Pedrazzoli, Angioletta Lasagna, Alessandro Vanoli, G. Gambini, G. Santacroce, Carlo Maria Rossi, Mariangela Delliponti, Catherine Klersy, Gino Roberto Corazza, Antonio Di Sabatino, C. Mengoli, Nicola Aronico, Federica Lepore, G. Broglio, Stefania Merli, G. Natalello, E. Alimenti, D. Scalvini, S. Muscarella, F. Agustoni, Alessia Pagani, Silvia Chiellino, Salvatore Corallo, Valeria Musella, Renato Cannizzaro, M. Vecchi, Flavio Caprioli, R. Gabbiadini, Arianna Dal Buono, Andrea C. Premoli, Laura D. Locati, Andrea Buda, Antonella Contaldo, Annalisa Schiepatti, Federico Biagi, Danila Morano, M. Cucè, Athanasios Κotsakis, Giuseppe De Lisi,

Colorectal Cancer Treatments and Studies

•The use of ICIs is associated with an increased risk of developing different forms of colitis.•The 12-month clinical outcome of ICI-induced colitis and the factors associated with lack of remission are poorly known.•A Crohn's disease-like pattern was associated with a worse 12-month clinical remission rate.•Having histopathological signs of microscopic colitis was associated with a better 12-month clinical remission rate. BackgroundData regarding the clinical outcome of patients with immune checkpoint inhibitor (ICI)-induced colitis are scant. We aimed to describe the 12-month clinical outcome of patients with ICI-induced colitis.Materials and methodsThis was a retrospective, European, multicentre study. Endoscopy/histology-proven ICI-induced colitis patients were enrolled. The 12-month clinical remission rate, defined as a Common Terminology Criteria for Adverse Events diarrhoea grade of 0-1, and the correlates of 12-month remission were assessed.ResultsNinety-six patients [male:female ratio 1.5:1; median age 65 years, interquartile range (IQR) 55.5-71.5 years] were included. Lung cancer (41, 42.7%) and melanoma (30, 31.2%) were the most common cancers. ICI-related gastrointestinal symptoms occurred at a median time of 4 months (IQR 2-7 months). An inflammatory bowel disease (IBD)-like pattern was present in 74 patients (77.1%) [35 (47.3%) ulcerative colitis (UC)-like, 11 (14.9%) Crohn's disease (CD)-like, 28 (37.8%) IBD-like unclassified], while microscopic colitis was present in 19 patients (19.8%). As a first line, systemic steroids were the most prescribed drugs (65, 67.7%). The 12-month clinical remission rate was 47.7 per 100 person-years [95% confidence interval (CI) 33.5-67.8). ICI was discontinued due to colitis in 66 patients (79.5%). A CD-like pattern was associated with remission failure (hazard ratio 3.84, 95% CI 1.16-12.69). Having histopathological signs of microscopic colitis (P = 0.049) and microscopic versus UC-/CD-like colitis (P = 0.014) were associated with a better outcome. Discontinuing the ICI was not related to the 12-month remission (P = 0.483). Four patients (3.1%) died from ICI-induced colitis.ConclusionsPatients with IBD-like colitis may need an early and more aggressive treatment. Future studies should focus on how to improve long-term clinical outcomes. Data regarding the clinical outcome of patients with immune checkpoint inhibitor (ICI)-induced colitis are scant. We aimed to describe the 12-month clinical outcome of patients with ICI-induced colitis. This was a retrospective, European, multicentre study. Endoscopy/histology-proven ICI-induced colitis patients were enrolled. The 12-month clinical remission rate, defined as a Common Terminology Criteria for Adverse Events diarrhoea grade of 0-1, and the correlates of 12-month remission were assessed. Ninety-six patients [male:female ratio 1.5:1; median age 65 years, interquartile range (IQR) 55.5-71.5 years] were included. Lung cancer (41, 42.7%) and melanoma (30, 31.2%) were the most common cancers. ICI-related gastrointestinal symptoms occurred at a median time of 4 months (IQR 2-7 months). An inflammatory bowel disease (IBD)-like pattern was present in 74 patients (77.1%) [35 (47.3%) ulcerative colitis (UC)-like, 11 (14.9%) Crohn's disease (CD)-like, 28 (37.8%) IBD-like unclassified], while microscopic colitis was present in 19 patients (19.8%). As a first line, systemic steroids were the most prescribed drugs (65, 67.7%). The 12-month clinical remission rate was 47.7 per 100 person-years [95% confidence interval (CI) 33.5-67.8). ICI was discontinued due to colitis in 66 patients (79.5%). A CD-like pattern was associated with remission failure (hazard ratio 3.84, 95% CI 1.16-12.69). Having histopathological signs of microscopic colitis (P = 0.049) and microscopic versus UC-/CD-like colitis (P = 0.014) were associated with a better outcome. Discontinuing the ICI was not related to the 12-month remission (P = 0.483). Four patients (3.1%) died from ICI-induced colitis. Patients with IBD-like colitis may need an early and more aggressive treatment. Future studies should focus on how to improve long-term clinical outcomes.