Clinical characteristics of gastrointestinal immune-related adverse events of immune checkpoint inhibitors and their association with survival

作     者：Kentaro Yamada Tsunaki Sawada Masanao Nakamura Takeshi Yamamura Keiko Maeda Eri Ishikawa Tadashi Iida Yasuyuki Mizutani Naomi Kakushima Takuya Ishikawa Kazuhiro Furukawa Eizaburo Ohno Takashi Honda Hiroki Kawashima Masatoshi Ishigami Satoshi Furune Tetsunari Hase Kenji Yokota Osamu Maeda Naozumi Hashimoto Masashi Akiyama Yuichi Ando Mitsuhiro Fujishiro 

作者机构：Department of Gastroenterology and HepatologyNagoya University Graduate School of MedicineNagoya City 4668560AichiJapan Department of EndoscopyNagoya University HospitalNagoya City 4668560AichiJapan Department of Clinical Oncology and ChemotherapyNagoya University HospitalNagoya City 4668560AichiJapan Department of Respiratory MedicineNagoya University Graduate School of MedicineNagoya City 4668560AichiJapan Department of DermatologyNagoya University Graduate School of MedicineNagoya City 4668560AichiJapan Department of Gastroenterology and HepatologyGraduate School of MedicineThe University of TokyoTokyo 1138655Japan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2021年第27卷第41期

页      面：7190-7206页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Kyowa Hakko Kirin Bayer Holding Ltd Tsumura & Co Novartis Pharma K.K Boehringer Ingelheim Sawai Pharmaceutical Co. Ltd Daiichi Sankyo Company Yakult Honsha Co. Ltd Nippon Kayaku Co. Ltd Eli Lilly Japan Taiho Pharmaceutical Bristol-Myers Squibb, BMS Otsuka Holdings Co. Ltd Mochida Pharmaceutical Company Roche Diagnostics K.K AstraZeneca K.K Ono Pharmaceutical AstraZeneca Chugai Pharmaceutical Co. Ltd Japan Society for the Promotion of Science, JSPS, (20K17046) 

主　　题：Colitis Cytotoxic T-lymphocyte antigen 4 Diarrhea Drug-related side effects and adverse reactions Immune checkpoint inhibitors Prognosis 

摘      要：BACKGROUND Despite the popularity of immune checkpoint inhibitors(ICIs)in the treatment of advanced cancer,patients often develop gastrointestinal(GI)and non-GI immune-related adverse events(irAEs).The clinical characteristics and survival outcomes of GI-irAEs have not been fully elucidated in previous *** necessitates the evaluation of the impact of GI-irAEs on patients receiving ICI *** To evaluate the clinical characteristics of GI-irAEs and their impact on survival in patients treated with *** In this single-center,retrospective,observational study,we reviewed the records of 661 patients who received ICIs for various cancers at Nagoya University Hospital from September 2014 to August *** analyzed the clinical characteristics of patients who received ICI *** also evaluated the correlation between GI-irAE development and prognosis in non-small cell lung cancer(LC)and malignant melanoma(MM).Kaplan-Meier analysis was used to compare the median overall survival(OS).Multivariate Cox proportional hazards models were used to identify prognostic factors.A P value0.05 was considered statistically *** GI-irAEs occurred in 34 of 605 patients(5.6%)treated with an anti-programmed cell death-1/programmed death-ligand 1(anti-PD-1/PD-L1)antibody alone and in nine of 56 patients(16.1%)treated with an anti-cytotoxic T-lymphocyte antigen 4(CTLA-4)antibody alone or a combination of anti-PD-1 and anti-CTLA-4 *** cumulative incidence and median daily diarrhea frequency were significantly higher in patients receiving anti-CTLA-4 antibodies(P0.05).In 130 patients with MM,OS was significantly prolonged in the group that continued ICI treatment despite the development of GI-irAEs compared to the group that did not experience GI-irAEs(P=0.035).In contrast,in 209 patients with non-small cell LC,there was no significant difference in OS between the *** multivariate analyses showed that a performance status of 2-3(ha