Abstract
Purpose: Immune checkpoint inhibitors (ICIs) are frequently associated with adverse events, often affecting the gastrointestinal tract. We conducted this study to determine the characteristics and outcomes of cancer patients with pre-existing microscopic colitis (MC) who underwent ICI treatment. Methods: In this retrospective study, we identified 10 patients with pre-existing MC who received ICIs at our center 01/2010–06/2020. Clinical characteristics and disease outcomes were recorded. Results: Of 124 screened patients with MC before ICI exposure, 10 had sufficient data to be included in the study. Melanoma (40%) and lung cancer (30%) were the most prevalent cancer types, with 70% of stage IV cancer. Patients received either anti-programmed death 1 regimen (8, 80%) or anti-programmed death ligand 1 agent (2, 20%). Six patients (60%) had collagenous colitis, and 4 (40%) had lymphocytic colitis. The median time from MC diagnosis to ICI initiation was 4 years, with 1 patient on budesonide within 2 months of ICI initiation. Eight patients (80%) developed colitis exacerbations after ICI and required selective immunosuppression. One patient received a compassionate-use fecal transplantation. The median time from ICI to colitis exacerbation was 14 days, with 40% and 50% of patients experiencing grade 3 diarrhea and grade 2 colitis, respectively, leading to hospitalization in 3 patients. Six patients received steroids and vedolizumab with no colitis recurrence. Of 8 patients who had colitis exacerbation, 6 resumed ICI therapy afterward; with 5 receiving concomitant vedolizumab for secondary prophylaxis. Conclusion: Our findings suggest that ICI exposure increases the risk of exacerbation of underlying colitis necessitating and responding to potent immunosuppression therapy.
Original language | English (US) |
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Pages (from-to) | 5429-5436 |
Number of pages | 8 |
Journal | Journal of cancer research and clinical oncology |
Volume | 149 |
Issue number | 8 |
DOIs | |
State | Published - Jul 2023 |
Keywords
- Cancer
- Diarrhea
- Immune checkpoint inhibitor
- Microscopic colitis
ASJC Scopus subject areas
- Oncology
- Cancer Research