Clinical and Colonoscopic Features of Immune Checkpoint Inhibitor-associated Colitis Shunichi Yanai 1 , Shotaro Nakamura 1 , Keisuke Kawasaki 1 , Risaburo Akasaka 1 , Yosuke Toya 1 , Tomofumi Oizumi 1 , Tomo Kumei 1 , Minami Hirai 1 , Shun Yamada 1 , Kyohei Sugai 1 , Kazuyuki Ishida 2,3 , Tamotsu Sugai 2 , Takayuki Matsumoto 1 1Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan 2Department of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan 3Department of Diagnostic Pathology, Dokkyo Medical University, Tochigi, Japan Keyword: 免疫チェックポイント阻害薬 , ICI , ニボルマブ , イピリムマブ , 免疫関連有害事象 , irAE , 大腸炎 pp.891-899
Published Date 2020/6/25
DOI https://doi.org/10.11477/mf.1403202071
  • Abstract
  • Look Inside
  • Reference

 We compared the prevalence of diarrhea and colitis in patients with cancer who were under an ICI(immune checkpoint inhibitor)monotherapy and those who were under a combination or a sequential therapy using two ICIs. Confirmation of marked apoptosis in the biopsy specimens was the basis for the diagnosis of ICI-associated colitis. There were 218 patients under ICI monotherapy and 32 patients under a combined or sequential therapy of two ICIs. In total, 27 patients(10.8%)complained of diarrhea and 9 patients(3.6%)were diagnosed with ICI-associated colitis. The prevalence of ICI-associated colitis was significantly higher in patients under combined or sequential ICIs(18.8%)than in those under monotherapy(1.4%, p=0.0002). Six patients were under combined or sequential ICIs and four of them belonged to the combined therapy group. Of the nine patients diagnosed with ICI-associated colitis, the endoscopic findings of ICI colitis mimicked those of ulcerative colitis in 5 patients, while the colonoscopic findings were nonspecific in the remaining four patients. These findings suggest that the risk of ICI-associated colitis is higher in patients under combined or sequential ICIs as compared to those under ICI monotherapy.

Copyright © 2020, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院