Abstract | BACKGROUND: METHODS: We evaluated data from a retrospective cohort from a single-center large academic hospital. The participants were all adult patients evaluated by endoscopy for suspected CPI enterocolitis between 3/2017 and 3/2019. The exposures were: Mayo Endoscopic Score (range 0-3). The subset was: oral budesonide, maximum dose 12 mg daily, administered minimum of 5 weeks. The main outcomes and measures were: Primary: time from first CPI exposure to first glucocorticoid use; use of systemic glucocorticoids; time from symptom onset to resolution; continuation of CPI therapy; number of additional CPI infusions received. Secondary: admissions for symptom control; novel irAE development; need for second-line immunosuppression; oncologic outcomes. RESULTS: We identified 38 patients with biopsy confirmed CPI enterocolitis, 13 in the microscopic colitis cohort, and 25 in the non- microscopic colitis cohort. Budesonide use was higher in the microscopic colitis cohort (12/13 vs 3/25, p < 0.001), and systemic glucocorticoid use was higher in non- microscopic colitis (22/25 vs. 3/13, p < 0.001). Time from symptom onset to resolution did not differ. Microscopic colitis patients more frequently remained on CPI after developing (entero) colitis (76.9% vs 16.0%, p < 0.001). Microscopic colitis patients tolerating further CPI received, on average, 4.2 CPI infusions more than non- microscopic colitis patients tolerating CPI (5.8 vs 1.6, p = 0.03). Microscopic colitis was associated with increased time-to-treatment-failure (HR 0.30, 95% CI 0.14-0.66) and progression-free survival (HR 0.22, 95% CI 0.07-0.70). CONCLUSIONS:
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Authors | Michael S Hughes, Gabriel E Molina, Steven T Chen, Hui Zheng, Vikram Deshpande, Riley Fadden, Ryan J Sullivan, Michael Dougan |
Journal | Journal for immunotherapy of cancer
(J Immunother Cancer)
Vol. 7
Issue 1
Pg. 292
(11 07 2019)
ISSN: 2051-1426 [Electronic] England |
PMID | 31699151
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Immunosuppressive Agents
- Budesonide
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Topics |
- Aged
- Biopsy
- Budesonide
(administration & dosage, adverse effects, therapeutic use)
- Colitis, Microscopic
(diagnosis, drug therapy, etiology)
- Colonoscopy
- Female
- Humans
- Immunosuppressive Agents
(administration & dosage, adverse effects, therapeutic use)
- Intestinal Mucosa
(immunology, metabolism, pathology)
- Male
- Middle Aged
- Retrospective Studies
- Severity of Illness Index
- Treatment Outcome
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