Comment on “Disease exacerbation is common in inflammatory bowel disease patients treated with immune checkpoint inhibitors for malignancy”

Abstract

We recently read with interest the original research article entitled "Disease exacerbation is common in inflammatory bowel disease patients treated with immune checkpoint inhibitors for malignancy". The abovementioned article is an observational retrospective cohort study, which could be of particular value for clinicians to understand how immunotherapy affects pre-existing enteral disease in inflammatory bowel disease patients. Although we appreciate the endeavor of Samuel Rubin et al, based on our in-depth analysis, we detected a potential shortcoming in this article; thus, we present our comments in this letter. If the authors contemplate these comments on their relevant research, we believe that their contribution would be considerable for future studies.

Keywords: Inflammatory bowel disease; Immune-related adverse events; Immune checkpoint inhibitors; Immunotherapy; Malignancy

Core Tip: Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment due to their ability to empower patients’ anti-neoplastic immune response. However, by empowering the immune system, ICIs can trigger off-site inflammation and autoimmunity, raising safety concerns every time these agents are considered for cancer patients with pre-existing autoimmune disorders such as inflammatory bowel disease (IBD). In this article, Samuel Rubin et al investigated how immunotherapy affects pre-existing enteral disease in a cohort of IBD patients on ICIs; however, we detected several limitations that need further consideration. Therefore, we would like to share our views on this interesting study.