Cargando…

Characteristics of Immune Checkpoint Inhibitor-Associated Gastritis: Report from a Major Tertiary Care Center

BACKGROUND: Immune checkpoint inhibitors (ICIs) have increased our ability to treat an ever-expanding number of cancers. We describe a case series of 25 patients who were diagnosed with gastritis following ICI therapy. MATERIALS AND METHODS: This was a retrospective study involving 1712 patients tre...

Descripción completa

Detalles Bibliográficos
Autores principales: Farha, Natalie, Faisal, Muhammad Salman, Allende, Daniela S, Sleiman, Joseph, Shah, Ravi, Farha, Nicole, Funchain, Pauline, Philpott, Jessica R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10400162/
https://www.ncbi.nlm.nih.gov/pubmed/36905577
http://dx.doi.org/10.1093/oncolo/oyad031
_version_ 1785084405361934336
author Farha, Natalie
Faisal, Muhammad Salman
Allende, Daniela S
Sleiman, Joseph
Shah, Ravi
Farha, Nicole
Funchain, Pauline
Philpott, Jessica R
author_facet Farha, Natalie
Faisal, Muhammad Salman
Allende, Daniela S
Sleiman, Joseph
Shah, Ravi
Farha, Nicole
Funchain, Pauline
Philpott, Jessica R
author_sort Farha, Natalie
collection PubMed
description BACKGROUND: Immune checkpoint inhibitors (ICIs) have increased our ability to treat an ever-expanding number of cancers. We describe a case series of 25 patients who were diagnosed with gastritis following ICI therapy. MATERIALS AND METHODS: This was a retrospective study involving 1712 patients treated for malignancy with immunotherapy at Cleveland Clinic from January 2011 to June 2019 (IRB 18-1225). We searched electronic medical records using ICD-10 codes for gastritis diagnosis confirmed on endoscopy and histology within 3 months of ICI therapy. Patients with upper gastrointestinal tract malignancy or documented Helicobacter pylori-associated gastritis were excluded. RESULTS: Twenty-five patients were found to meet the criteria for diagnosis of gastritis. Of these 25 patients, most common malignancies were non–small cell lung cancer (52%) and melanoma (24%). Median number of infusions preceding symptoms was 4 (1-30) and time to symptom onset 2 (0.5-12) weeks after last infusion. Symptoms experienced were nausea (80%), vomiting (52%), abdominal pain (72%), and melena (44%). Common endoscopic findings were erythema (88%), edema (52%), and friability (48%). The most common diagnosis of pathology was chronic active gastritis in 24% of patients. Ninety-six percent received acid suppression treatment and 36% of patients also received steroids with an initial median dose of prednisone 75 (20-80) mg. Within 2 months, 64% had documented complete resolution of symptoms and 52% were able to resume immunotherapy. CONCLUSION: Patients presenting with nausea, vomiting, abdominal pain, or melena following immunotherapy should be assessed for gastritis and if other causes are excluded, may require treatment as consideration for complication of immunotherapy.
format Online
Article
Text
id pubmed-10400162
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-104001622023-08-04 Characteristics of Immune Checkpoint Inhibitor-Associated Gastritis: Report from a Major Tertiary Care Center Farha, Natalie Faisal, Muhammad Salman Allende, Daniela S Sleiman, Joseph Shah, Ravi Farha, Nicole Funchain, Pauline Philpott, Jessica R Oncologist Immuno-Oncology BACKGROUND: Immune checkpoint inhibitors (ICIs) have increased our ability to treat an ever-expanding number of cancers. We describe a case series of 25 patients who were diagnosed with gastritis following ICI therapy. MATERIALS AND METHODS: This was a retrospective study involving 1712 patients treated for malignancy with immunotherapy at Cleveland Clinic from January 2011 to June 2019 (IRB 18-1225). We searched electronic medical records using ICD-10 codes for gastritis diagnosis confirmed on endoscopy and histology within 3 months of ICI therapy. Patients with upper gastrointestinal tract malignancy or documented Helicobacter pylori-associated gastritis were excluded. RESULTS: Twenty-five patients were found to meet the criteria for diagnosis of gastritis. Of these 25 patients, most common malignancies were non–small cell lung cancer (52%) and melanoma (24%). Median number of infusions preceding symptoms was 4 (1-30) and time to symptom onset 2 (0.5-12) weeks after last infusion. Symptoms experienced were nausea (80%), vomiting (52%), abdominal pain (72%), and melena (44%). Common endoscopic findings were erythema (88%), edema (52%), and friability (48%). The most common diagnosis of pathology was chronic active gastritis in 24% of patients. Ninety-six percent received acid suppression treatment and 36% of patients also received steroids with an initial median dose of prednisone 75 (20-80) mg. Within 2 months, 64% had documented complete resolution of symptoms and 52% were able to resume immunotherapy. CONCLUSION: Patients presenting with nausea, vomiting, abdominal pain, or melena following immunotherapy should be assessed for gastritis and if other causes are excluded, may require treatment as consideration for complication of immunotherapy. Oxford University Press 2023-03-11 /pmc/articles/PMC10400162/ /pubmed/36905577 http://dx.doi.org/10.1093/oncolo/oyad031 Text en © The Author(s) 2023. Published by Oxford University Press. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Immuno-Oncology
Farha, Natalie
Faisal, Muhammad Salman
Allende, Daniela S
Sleiman, Joseph
Shah, Ravi
Farha, Nicole
Funchain, Pauline
Philpott, Jessica R
Characteristics of Immune Checkpoint Inhibitor-Associated Gastritis: Report from a Major Tertiary Care Center
title Characteristics of Immune Checkpoint Inhibitor-Associated Gastritis: Report from a Major Tertiary Care Center
title_full Characteristics of Immune Checkpoint Inhibitor-Associated Gastritis: Report from a Major Tertiary Care Center
title_fullStr Characteristics of Immune Checkpoint Inhibitor-Associated Gastritis: Report from a Major Tertiary Care Center
title_full_unstemmed Characteristics of Immune Checkpoint Inhibitor-Associated Gastritis: Report from a Major Tertiary Care Center
title_short Characteristics of Immune Checkpoint Inhibitor-Associated Gastritis: Report from a Major Tertiary Care Center
title_sort characteristics of immune checkpoint inhibitor-associated gastritis: report from a major tertiary care center
topic Immuno-Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10400162/
https://www.ncbi.nlm.nih.gov/pubmed/36905577
http://dx.doi.org/10.1093/oncolo/oyad031
work_keys_str_mv AT farhanatalie characteristicsofimmunecheckpointinhibitorassociatedgastritisreportfromamajortertiarycarecenter
AT faisalmuhammadsalman characteristicsofimmunecheckpointinhibitorassociatedgastritisreportfromamajortertiarycarecenter
AT allendedanielas characteristicsofimmunecheckpointinhibitorassociatedgastritisreportfromamajortertiarycarecenter
AT sleimanjoseph characteristicsofimmunecheckpointinhibitorassociatedgastritisreportfromamajortertiarycarecenter
AT shahravi characteristicsofimmunecheckpointinhibitorassociatedgastritisreportfromamajortertiarycarecenter
AT farhanicole characteristicsofimmunecheckpointinhibitorassociatedgastritisreportfromamajortertiarycarecenter
AT funchainpauline characteristicsofimmunecheckpointinhibitorassociatedgastritisreportfromamajortertiarycarecenter
AT philpottjessicar characteristicsofimmunecheckpointinhibitorassociatedgastritisreportfromamajortertiarycarecenter