The characteristics of nivolumab-induced colitis: an evaluation of three cases and a literature review.

Abstract:

BACKGROUND:The use of immune-checkpoint inhibitors in cancer treatment has become increasingly common, resulting in an increase in the incidence of related side effects. Diarrhoea and colitis have been previously documented as gastrointestinal tract-related side effects of immune-checkpoint inhibitors. Although PD-1/PD-L1 inhibitors produce fewer side effects than CTLA-4 inhibitors, diarrhoea and colitis continue to be reported. However, little is known about the endoscopic features associated with PD-1/PD-L1 inhibitors. In this report, we describe three cases of colitis induced by a PD-1 inhibitor nivolumab. These cases showed endoscopic findings characteristic of ulcerative colitis (UC). Treatment was in accordance with UC therapy, which resulted in beneficial outcomes. CASE PRESENTATION:Three patients with lung cancer treated with nivolumab presented with diarrhoea with (case 2) or without haematochezia (cases 1 and 3). Treatment with nivolumab was ceased and colonoscopy was performed, revealing endoscopic features similar to those of UC. These patients were diagnosed with nivolumab-induced colitis. Case 1 was treated with mesalazine, whereas cases 2 and 3 were treated with corticosteroids. Subsequently, their symptoms improved. CONCLUSIONS:Nivolumab-induced colitis exhibited similar characteristics to UC. Treatment was similar to that for UC and was successful.

journal_name

BMC Gastroenterol

journal_title

BMC gastroenterology

authors

Yamauchi R,Araki T,Mitsuyama K,Tokito T,Ishii H,Yoshioka S,Kuwaki K,Mori A,Yoshimura T,Tsuruta O,Torimura T

doi

10.1186/s12876-018-0864-1

subject

Has Abstract

pub_date

2018-08-31 00:00:00

pages

135

issue

1

issn

1471-230X

pii

10.1186/s12876-018-0864-1

journal_volume

18

pub_type

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