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

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World Journal of Clinical Cases 2022年第6期10卷 1787-1794页

作者： Samuel J S Rubin tatiana balabanis John Gubatan Aida Habtezion Division of Gastroenterology and Hepatology Department of MedicineStanford University School of MedicineStanfordCA 94305United States

BACKGROUND Colitis is a known potential toxicity of immune checkpoint inhibitors(ICIs).Studies evaluating the risk of disease exacerbation following ICI treatment in patients with pre-existing inflammatory bowel disease(IBD)are *** To assess the clinical characteristics of IBD patients treated with ICIs and determine prevalence of subsequent IBD *** We conducted a retrospective cohort study of all patients in the Stanford Research Repository database with pre-existing IBD who were exposed to *** The prevalence of IBD exacerbation following ICI was 36.8% amongst 19 patients meeting inclusion *** with exacerbations had more gastrointestinalrelated hospitalizations(4 of 7)than patients without exacerbations(0 of 12;P=0.0090).CONCLUSION The prevalence of IBD exacerbations following ICI was higher than reported rates of ICI-induced colitis and diarrhea in the general population and was associated with hospitalization.

关键词： Inflammatory bowel disease Immune checkpoint inhibitors Immunotherapy Malignancy

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Artificial intelligence applications in inflammatory bowel disease:Emerging technologies and future directions

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World Journal of Gastroenterology 2021年第17期27卷 1920-1935页

作者： John Gubatan Steven Levitte Akshar Patel tatiana balabanis Mike T Wei Sidhartha R Sinha Division of Gastroenterology and Hepatology Stanford University School of MedicineRedwood CityCA 94063United States

Inflammatory bowel disease(IBD)is a complex and multifaceted disorder of the gastrointestinal tract that is increasing in incidence worldwide and associated with significant *** rapid accumulation of large datasets from electronic health records,high-definition multi-omics(including genomics,proteomics,transcriptomics,and metagenomics),and imaging modalities(endoscopy and endomicroscopy)have provided powerful tools to unravel novel mechanistic insights and help address unmet clinical needs in *** the application of artificial intelligence(AI)methods has facilitated the analysis,integration,and interpretation of large datasets in IBD,significant heterogeneity in AI methods,datasets,and clinical outcomes and the need for unbiased prospective validations studies are current barriers to incorporation of AI into clinical *** purpose of this review is to summarize the most recent advances in the application of AI and machine learning technologies in the diagnosis and risk prediction,assessment of disease severity,and prediction of clinical outcomes in patients with IBD.

关键词： Artificial intelligence Machine learning Inflammatory bowel disease Crohn’s disease Ulcerative colitis Clinical outcomes

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Immune checkpoint inhibitor-mediated colitis is associated with cancer overall survival

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World Journal of Gastroenterology 2022年第39期28卷 5750-5763页

作者： Alexa R Weingarden John Gubatan Sundeep Singh tatiana Clorice balabanis Akshar Patel Arpita Sharma Aida Habtezion Medicine Division of Gastroenterology and HepatologyStanford University School of MedicineStanfordCA 94305United States

BACKGROUND Immune checkpoint inhibitor-mediated colitis(IMC)is a common adverse event following immune checkpoint inhibitor(ICI)therapy for *** has been associated with improved overall survival(OS)and progression-free survival(PFS),but data are limited to a single site and predominantly for melanoma *** To determine the association of IMC with OS and PFS and identify clinical predictors of *** We performed a retrospective case-control study including 64 ICI users who developed IMC matched according to age,sex,ICI class,and malignancy to a cohort of ICI users without IMC,from May 2011 to May *** univariate and multivariate logistic regression,we determined association of presence of IMC on OS,PFS,and clinical predictors of ***-Meier curves were gen-erated to compare OS and PFS between ICI users with and without *** IMC was significantly associated with a higher OS(mean 24.3 mo vs 17.7 mo,P=0.05)but not PFS(mean 13.7 mo vs 11.9 mo,P=0.524).IMC was significantly associated with OS greater than 12 mo[Odds ratio(OR)2.81,95%confidence interval(CI)1.17-6.77].Vitamin D supplementation was significantly associated with increased risk of IMC(OR 2.48,95%CI 1.01-6.07).CONCLUSION IMC was significantly associated with OS greater than 12 *** contrast to prior work,we found that vitamin D use may be a risk factor for IMC.

关键词： Immune checkpoint inhibitors Immune checkpoint inhibitor-mediated colitis Immune-related adverse events

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