%0 Journal Article
%T A 1-year follow-up study on checkpoint inhibitor-induced colitis: results from a European consortium.
%A Lenti MV
%A Ribaldone DG
%A Borrelli de Andreis F
%A Vernero M
%A Barberio B
%A De Ruvo M
%A Savarino EV
%A Kav T
%A Blesl A
%A Franzoi M
%A Gröchenig HP
%A Pugliese D
%A Ianiro G
%A Porcari S
%A Cammarota G
%A Gasbarrini A
%A Spagnuolo R
%A Ellul P
%A Foteinogiannopoulou K
%A Koutroubakis I
%A Argyriou K
%A Cappello M
%A Jauregui-Amezaga A
%A Demarzo MG
%A Silvestris N
%A Armuzzi A
%A Sottotetti F
%A Bertani L
%A Festa S
%A Eder P
%A Pedrazzoli P
%A Lasagna A
%A Vanoli A
%A Gambini G
%A Santacroce G
%A Rossi CM
%A Delliponti M
%A Klersy C
%A Corazza GR
%A Di Sabatino A
%A
%J ESMO Open
%V 9
%N 7
%D 2024 Jul 5
%M 38970840
%F 6.883
%R 10.1016/j.esmoop.2024.103632
%X BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.