Systematic review: disease activity indices for immune checkpoint inhibitor‐associated enterocolitis

Abstract

Background: Although there is interest in developing pharmacotherapies for the treatment of immune checkpoint inhibitor-associated enterocolitis (ICIC), there is currently no consensus on how to optimally measure disease activity in this condition. Aims:To identify all scoring indices used for the measurement of disease activity in ICIC, assess their operating properties, and explore their potential utility as outcome measures. Methods:We searched MEDLINE, EMBASE and the Cochrane Library from inception to November 2020 to identify studies that evaluated disease activity and severity in patients with ICI-associated enterocolitis. These scoring tools could be designed specifically for ICIC or adapted from other diseases, and assessed clinical, endoscopic, or histologic disease activity. Results:Sixty-four studies were included. The Common Terminology Criteria for Adverse Events is commonly used to describe symptoms, although has only been partially validated and was not designed as a disease activity index. Endoscopic and histologic indices used in inflammatory bowel disease have been adopted for ICIC including the Mayo Endoscopic Subscore,

Identification of useful genes from multiple microarrays for ulcerative colitis diagnosis based on machine learning methods

“…As a result, it has become a global refractory disease with worldwide shifting epidemiological characteristics. Previous studies have found that immune dysfunction contributes to the progression of UC 4 . Specifically, in B cells, UC patients showed an increasing percentage of CD23 B naive cells than the normal individuals, while intestinal CD11b + B Cells relieve colitis by secreting immunoglobulin A 5 , 6 .…”

Recommendations for standardizing biopsy acquisition and histological assessment of immune checkpoint inhibitor-associated colitis

“…Full results from this systematic review have been previously published. 14 In brief, although 83% of included studies reported histological findings associated with ICIC, no ICIC-specific histology indices were identified. Several instruments originally developed for ulcerative colitis (UC) have been applied to patients with ICIC, including the Geboes score, 15 Robarts Histopathology Index (RHI), 16 and Nancy index.…”

“…These statements were informed by a systematic literature review conducted by our group. 14 We searched MEDLINE, Embase, the Cochrane CENTRAL Library, and conference proceedings from Digestive Disease Week, the United European Gastroenterology Week, the Society for Immunotherapy of Cancer Annual Meeting, and the American Society of Clinical Oncology National Meeting to identify studies evaluating disease activity in patients with ICIC. Search terms captured ICIs, diarrhea, and enterocolitis.…”

Management of immune checkpoint inhibitor in patients with cancer and pre-existing inflammatory bowel disease: Recommendations from the GETAID

“…Common Terminology Criteria for Adverse Events (CTCAE) grading for colitis or diarrhoea is commonly used for IMDC ( Table 1 ) [21] . However, there are currently no validated clinical, endoscopic, or histologic outcomes to assess disease activity in IMDC.…”

“…However, there are currently no validated clinical, endoscopic, or histologic outcomes to assess disease activity in IMDC. Waiting for development and validation of reliable and dedicated outcome measures for IMDC, current IBD outcome measures may be also used to assess IMDC severity [21] . In patients with pre-existing IBD treated with ICI having digestive symptoms, similar management as for IBD relapse including stool cultures and Clostridioides difficile toxin testing as well as blood tests including cytomegalovirus PCR, may be useful [25 , 26] .…”