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Identifying Patients at Risk for Immune Checkpoint Inhibitor-Induced Colitis: Evidence From a Real-World Oncology
Fady Daniel1, Tasnim Diab2, Jad Bou Khalil1
1Department of Internal Medicine, Division of Gastroenterology and Hepatology, American University of Beirut Medical Center, Beirut, Lebanon.
Journal of Immunotherapy (Hagerstown, Md. : 1997)
|August 6, 2026
Summary
Immune checkpoint inhibitor (ICI) colitis is uncommon but serious, affecting 2.4% of patients. Autoimmune disease, combination immunotherapy, and targeted therapy increase risk, necessitating closer monitoring for improved management.
Area of Science:
- Oncology
- Immunology
- Gastroenterology
Background:
- Immune checkpoint inhibitors (ICIs) have transformed cancer treatment but can cause immune-related adverse events.
- Immune-related adverse events, such as colitis, can lead to significant morbidity and treatment cessation.
- Limited data exist on ICI-induced colitis incidence and risk factors in the Middle East.
Purpose of the Study:
- To determine the incidence and identify risk factors for immune checkpoint inhibitor-induced colitis (ICI-colitis) in a Middle Eastern tertiary care center.
- To analyze clinical characteristics and management strategies for ICI-colitis.
Main Methods:
- Retrospective study of adult cancer patients treated with ICIs from December 2018 to March 2023.
- Data collection included clinical and treatment variables.
- Univariable and multivariable logistic regression analyses were used to identify predictors of colitis.
Main Results:
- 19 out of 784 patients (2.4%) developed ICI-colitis, mostly moderate to severe.
- 78.9% of patients discontinued ICI therapy; 68.4% received corticosteroids with a 92.3% response rate.
- Independent predictors for ICI-colitis included autoimmune disease (OR=6.10), combination immunotherapy (OR=3.56), and concurrent targeted therapy (OR=3.88).
Conclusions:
- ICI-induced colitis is an uncommon but clinically significant toxicity.
- Identifying patients at higher risk, such as those with autoimmune disease or on combination/targeted therapies, can guide closer monitoring.
- Proactive management with corticosteroids is effective, but vigilance is crucial for optimal patient outcomes.
