ANTI-PD-1 Induced Colitis: A Case Series of 25 Patients

Kim, James; Shia, Jinru; Schattner, Mark; Gerdes, Hans; Markowitz, Arnold J.; Kurtz, Robert C.; Ludwig, Emmy; Shah, Pari; Gambarin‐Gelwan, Maya; Sinha, Smrita; Mendelsohn, Robin B.

doi:10.1016/s0016-5085(17)32805-6

Cited by 5 publications

(9 citation statements)

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“…Interestingly, in the absence of IL-10, blocking of PD-1 favored development of colitis in these mice. Numerous reports show that colitis development remains a complication after treatment of cancer patients with an anti-PD-1 checkpoint inhibitor (43)(44)(45).…”

Section: Methodsmentioning

confidence: 99%

Intestinal development and homeostasis require activation and apoptosis of diet-reactive T cells

Visekruna¹,

Hartmann²,

Sillke³

et al. 2019

Journal of Clinical Investigation

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Section: Methodsmentioning

confidence: 99%

Intestinal development and homeostasis require activation and apoptosis of diet-reactive T cells

Visekruna¹,

Hartmann²,

Sillke³

et al. 2019

Journal of Clinical Investigation

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“…A differential response to infliximab based on checkpoint inhibitor regimen was less apparent than in the corticosteroid subgroup, although this was challenging to ascertain given there was only one anti-PD-1/L1 treated study included. 42 Notably, all 6…”

Section: Discussionmentioning

confidence: 99%

“…10,25,31,34,40 A response rate of 78% (95% CI 68-85) was observed in the 12 studies of anti-CTLA-4 containing regimen-treated groups, which was associated with a moderate degree of statistically significant heterogeneity (I 2 = 42%, P = 0.06) ( Figure 3A). Only Kim et al 42 reported outcomes in patients exclusively receiving anti-PD-1/L1 monotherapy (n = 6, response rate 100%), and so a pooled response could not be generated in this subgroup.…”

Section: Efficacy Of Infliximabmentioning

confidence: 99%

Systematic review with meta‐analysis: effectiveness of anti‐inflammatory therapy in immune checkpoint inhibitor‐induced enterocolitis

Ibraheim

Baillie

Samaan

et al. 2020

Aliment Pharmacol Ther

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Summary Background Immune checkpoint inhibitors have revolutionised cancer treatment, but at the cost of off‐target immune‐mediated organ damage. This includes checkpoint inhibitor‐induced enterocolitis which frequently requires hospitalisation and may be life‐threatening. Empiric treatment typically includes corticosteroids and infliximab, although no large‐scale studies have confirmed their effectiveness. Aim To investigate the effectiveness of anti‐inflammatory therapy in checkpoint inhibitor‐induced enterocolitis Methods We performed a systematic review and meta‐analysis of studies reporting clinical outcomes of checkpoint inhibitor‐induced enterocolitis in adult cancer patients treated with anti‐inflammatory agents. We searched Medline, EMBASE, and the Cochrane library through April and extracted the proportion of patients responding to anti‐inflammatory therapy. Variation in effect size was studied using a random‐effects meta‐regression analysis, with checkpoint inhibitor agent and tumour type as the variables. Results Data were pooled from 1210 treated patients across 39 studies. Corticosteroids were effective in 59% (95% CI 54‐ 65) of patients, with response significantly more favourable in patients treated with anti‐PD‐1/L1 monotherapy, compared with anti‐CTLA‐4 containing regimens (78%, 95% CI 69‐85 vs 56 %, 95% CI 49‐63, P = 0.003), and more favourable in lung cancer patients compared with melanoma patients (88%, 95% CI 62‐97 vs 55%, 95% CI 47‐63, P = 0.04). Infliximab was effective in 81% (95% CI 73‐87) of patients, and vedolizumab in 85% (95% CI 60‐96). Conclusion Corticosteroids, infliximab and vedolizumab, are effective in the treatment of checkpoint inhibitor‐induced enterocolitis. Checkpoint inhibitor regimen and cancer type were significant moderators in response to corticosteroid therapy.

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“…184 The class of programmed cell death protein 1 (PD-1) antagonist checkpoint inhibitors, such as nivolumab, have also been reported to induce colitis. 185,186 Such cases of drug-induced colitis often require medication discontinuation and/or treatment with either steroids or infliximab.…”

Section: Pathways That Exacerbate Ibdmentioning

confidence: 99%

The current state of the art for biological therapies and new small molecules in inflammatory bowel disease

et al. 2018

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The emergence of biologic therapies is arguably the greatest therapeutic advance in the care of inflammatory bowel disease (IBD) to date, allowing directed treatments targeted at highly specific molecules shown to play critical roles in disease pathogenesis, with advantages in potency and selectivity. Furthermore, a large number of new biologic and small-molecule therapies in IBD targeting a variety of pathways are at various stages of development that should soon lead to a dramatic expansion in our therapeutic armamentarium. Additionally, since the initial introduction of biologics, there have been substantial advances in our understanding as to how biologics work, the practical realities of their administration, and how to enhance their efficacy and safety in the clinical setting. In this review, we will summarize the current state of the art for biological therapies in IBD, both in terms of agents available and their optimal use, as well as preview future advances in biologics and highly targeted small molecules in the IBD field.

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ANTI-PD-1 Induced Colitis: A Case Series of 25 Patients

Cited by 5 publications

References 0 publications

Intestinal development and homeostasis require activation and apoptosis of diet-reactive T cells

Intestinal development and homeostasis require activation and apoptosis of diet-reactive T cells

Systematic review with meta‐analysis: effectiveness of anti‐inflammatory therapy in immune checkpoint inhibitor‐induced enterocolitis

The current state of the art for biological therapies and new small molecules in inflammatory bowel disease

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