Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2022; 10(6): 1787-1794
Published online Feb 26, 2022. doi: 10.12998/wjcc.v10.i6.1787
Disease exacerbation is common in inflammatory bowel disease patients treated with immune checkpoint inhibitors for malignancy
Samuel J S Rubin, Tatiana Balabanis, John Gubatan, Aida Habtezion
Samuel J S Rubin, Tatiana Balabanis, John Gubatan, Aida Habtezion, Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States
Author contributions: Rubin SJS, Gubatan J and Habtezion A helped plan the study, interpret data, and draft the manuscript. Rubin SJS, Balabanis T, Gubatan J and Habtezion A interpreted data; Balabanis T collected data; all authors approved the final draft submitted.
Supported by the Stanford Medical Scholars Fellowship Program to Rubin SJS.
Institutional review board statement: The study is approved by the Stanford Institutional Review Board (57160).
Informed consent statement: Because of the retrospective and anonymous character of this study, the need for informed consent was waived by the institutional review board.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Data sharing statement: The full data underlying this article cannot be shared publicly due to privacy of the individuals that participated in the study. The de-identified data will be shared on reasonable request to the corresponding authors.
STROBE statement: Authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Samuel J S Rubin, PhD, Postdoctoral Fellow, Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Alway Building, Room M211, 300 Pasteur Drive, Stanford, CA 94305, United States. yrubin@stanford.edu
Received: May 28, 2021
Peer-review started: June 1, 2021
First decision: July 14, 2021
Revised: July 19, 2021
Accepted: January 11, 2022
Article in press: January 11, 2022
Published online: February 26, 2022
ARTICLE HIGHLIGHTS
Research background

Colitis and diarrhea are immune-related adverse events associated with immune checkpoint inhibitor (ICI) therapy.

Research motivation

The risk of inflammatory bowel disease (IBD) exacerbation following ICI treatment of malignancy in these patients is poorly understood.

Research objectives

We aimed to understand clinical characteristics of IBD patients treated with ICIs for malignancy and their clinical outcomes.

Research methods

We conducted a retrospective cohort study of all IBD patients treated with ICIs for malignancy and Stanford Healthcare.

Research results

The prevalence of IBD exacerbation amongst patients treated with ICI therapy for malignancy was 36.8%. Individuals with exacerbation of pre-existing IBD had more gastrointestinal-related hospitalizations.

Research conclusions

IBD exacerbation amongst patients treated with ICIs for malignancy was higher than reported rates of colitis and diarrhea in the general population treated with ICIs for malignancy.

Research perspectives

IBD patients are vulnerable to disease exacerbation when treated with ICIs for malignancy, and close monitoring should be implemented. Further studies will aim to better understand what factors modulate risk of IBD exacerbation in patients following ICI administration.