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Ipilimumab-induced colitis: experience from a tertiary referral center
Anthony O'Connor1, Maria Marples2, Clive Mulatero2
1Leeds Gastroenterology Institute, Bexley Wing, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK.
Therapeutic Advances in Gastroenterology
|July 2, 2016
Summary
Ipilimumab-induced diarrhea occurred in 19.3% of patients, manageable with symptomatic treatment for mild cases. For severe diarrhea, infliximab was more effective than glucocorticosteroids.
Area of Science:
- Oncology
- Immunology
- Gastroenterology
Background:
- Ipilimumab, a CTLA-4 inhibitor, treats metastatic melanoma.
- It can cause immune-mediated adverse events, including severe diarrhea.
- Postmarketing data on ipilimumab-induced diarrhea is limited.
Purpose of the Study:
- To investigate the incidence and management of ipilimumab-induced diarrhea.
- To compare the efficacy of different treatments for ipilimumab-induced diarrhea.
Main Methods:
- Retrospective chart review of 83 metastatic melanoma patients treated with ipilimumab.
- Data extracted from oncology databases, medical records, and prescription data.
- Analysis of diarrhea incidence, severity, and treatment outcomes.
Main Results:
- Diarrhea occurred in 19.3% of patients, with a median grade of 2.
- Antidiarrheal agents resolved grade 1 diarrhea in all cases.
- Infliximab resolved severe diarrhea in 100% of cases, compared to 50% for glucocorticosteroids.
Conclusions:
- Real-world incidence of ipilimumab-related diarrhea is substantial but lower than in clinical trials.
- Grade 1 diarrhea is manageable symptomatically.
- Infliximab is highly effective for severe ipilimumab-induced diarrhea, warranting further research into its early use.
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