Immune Checkpoint Inhibitor Therapy in Patients With Preexisting Inflammatory Bowel Disease
Year: 2019
Type: article
Study design: Observational Study
Abstract: PURPOSE The risk of immune checkpoint inhibitor therapy–related GI adverse events in patients with cancer and inflammatory bowel disease (IBD) has not been well described. We characterized GI adverse events in patients with underlying IBD who received immune checkpoint inhibitors. PATIENTS AND METHODS We performed a multicenter, retrospective study of patients with documented IBD who received immune checkpoint inhibitor therapy between January 2010 and February 2019. Backward selection and multivariate logistic regression were conducted to assess risk of GI adverse events. RESULTS Of the 102 included patients, 17 received therapy targeting cytotoxic T-lymphocyte antigen-4, and 85 received monotherapy targeting programmed cell death 1 or its ligand. Half of the patients had Crohn’s disease, and half had ulcerative colitis. The median time from last active IBD episode to immunotherapy initiation was 5 years (interquartile range, 3-12 years). Forty-three patients were not receiving treatment of IBD. GI adverse events occurred in 42 patients (41%) after a median of 62 days (interquartile range, 33-123 days), a rate higher than that among similar patients without underlying IBD who were treated at centers participating in the study (11%; P < .001). GI events among patients with IBD included grade 3 or 4 diarrhea in 21 patients (21%). Four patients experienced colonic perforation, 2 of whom required surgery. No GI adverse event–related deaths were recorded. Anti–cytotoxic T-lymphocyte antigen-4 therapy was associated with increased risk of GI adverse events on univariable but not multivariable analysis (odds ratio, 3.19; 95% CI, 1.8 to 9.48; P = .037; and odds ratio, 4.72; 95% CI, 0.95 to 23.53; P = .058, respectively). CONCLUSION Preexisting IBD increases the risk of severe GI adverse events in patients treated with immune checkpoint inhibitors.
Source: Journal of Clinical Oncology
DOI: 10.1200/jco.19.01674
Authors: Hamzah Abu-Sbeih, David M. Faleck, Biagio Ricciuti, Robin B. Mendelsohn, Abdul R. Naqash, Justine V. Cohen, Maclean C. Sellers, Aanika Balaji, Guy Ben-Betzalel, Ibraheim Hajir, Jiajia Zhang, Mark M. Awad, Giulia C. Leonardi, Douglas B. Johnson, David J. Pinato, Dwight H. Owen, Sarah A. Weiss, Giuseppe Lamberti, Mark P. Lythgoe, Lisa Manuzzi, Christina Arnold, Wei Qiao, Jarushka Naidoo, Gal Markel, Nick Powell, Sai-Ching J. Yeung, Elad Sharon, Michael Dougan, Yinghong Wang
Institutions: The University of Texas MD Anderson Cancer Center, Memorial Sloan Kettering Cancer Center, University of Perugia, Dana-Farber Cancer Institute, East Carolina University, Harvard University, Massachusetts General Hospital, Johns Hopkins University, Sheba Medical Center, King's College London, University of Catania, Vanderbilt University Medical Center, Hammersmith Hospital, Imperial College London, The Ohio State University, Yale University, IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola, University of Bologna, National Institutes of Health, National Cancer Institute
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Awards: G1044130170, G111615301, G122759566, G1808489503, G2539039149, G4560519890, G5444104917, G6715383753, Vanderbilt Clinical Oncology Research Career Development Award, Cancer Center Support Grant, Cancer Center Support Grant, OSU K12 Training Grant in Oncology, Yale Clinical and Translational Science Award
OpenAlex ID: W2994201430