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