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Concurrent immune checkpoint inhibition and selective immunosuppressive therapy in patients with immune-related enterocolitis

Authors :
Wei Qiao
John A Thompson
Hamzah Abu-Sbeih
Yinghong Wang
Michael Dougan
Mehmet Altan
Michael A Postow
Yousef R Badran
Fangwen Zou
Anusha S Thomas
Sienna M Durbin
Barbara E Dutra
Donna E Leet
Po-Ying Lai
Nora K Horick
David M Faleck
Source :
Journal for ImmunoTherapy of Cancer, Vol 11, Iss 6 (2023)
Publication Year :
2023
Publisher :
BMJ Publishing Group, 2023.

Abstract

Purpose Immune checkpoint inhibitor (ICI) therapy is often suspended because of immune-related enterocolitis (irEC). We examined the effect of resumption of ICIs with or without concurrent selective immunosuppressive therapy (SIT) on rates of symptom recurrence and survival outcomes.Methods This retrospective, multicenter study examined patients who were treated with ICI and developed irEC requiring SIT (infliximab or vedolizumab) for initial symptom control or to facilitate steroid tapering between May 2015 and June 2020. After symptom resolution, patients were restarted either on ICI alone or on concurrent ICI and SIT at the discretion of the treating physicians. The associations between irEC recurrence and treatment group were assessed via univariate analyses and multivariate logistic regression. Cox proportional hazards model was used for survival analysis.Results Of the 138 included patients who required SIT for initial irEC symptom control, 61 (44.2%) patients resumed ICI without concurrent SIT (control group) and 77 (55.8%) patients resumed ICI therapy with concurrent SIT: 33 with infliximab and 44 with vedolizumab. After symptom resolution, patients in the control group were more commonly restarted on a different ICI regimen (65.6%) compared with those receiving SIT (31.2%) (p

Details

Language :
English
ISSN :
20511426
Volume :
11
Issue :
6
Database :
Directory of Open Access Journals
Journal :
Journal for ImmunoTherapy of Cancer
Publication Type :
Academic Journal
Accession number :
edsdoj.68c7351fed9c487bae41ff9ca5853270
Document Type :
article
Full Text :
https://doi.org/10.1136/jitc-2023-007195