Huitema, J.S. (2025) Clinical, endoscopic and histological features associated with treatment outcomes in patients with checkpoint inhibitor colitis. thesis, Medicine.
Full text available on request.Abstract
Background Immune checkpoint inhibitors (ICIs) have transformed cancer treatment by enhancing the immune system's ability to fight tumors. However, ICIs can cause immune-related adverse events (irAEs), particularly ICI-colitis, often leading to therapy discontinuation. This study aims to identify clinical, endoscopic, and histopathological features associated with treatment response in ICI-colitis to guide optimal management strategies. Methods This retrospective, single-center cohort study included 120 patients with ICI-colitis at UMCG from 2015 to 2024. Patients with histologically confirmed ICI-colitis were included. Data on clinical features, including CTCAE grade, Mayo score, and histological characteristics, were collected. Univariate and multivariate logistic regression was conducted to identify factors associated with treatment outcomes. Results The median age of the 120 patients included was 65 years, with 58% male. Of these, 116 patients received first-line corticosteroids and 36 patients subsequently received second-line treatment. Sixty-seven patients had received anti-PD(L)-1 monotherapy. Logistic regression identified that a Mayo score ≥ 2 was a significant predictor of a lower likelihood of achieving complete remission with corticosteroids (P=0.046; OR 0.33). Patients with a Mayo score ≥ 2 have a significantly lower chance of achieving remission — 67% lower — compared to those with a Mayo score of 0. CTCAE grade did not predict the need for second-line treatment. Conclusion A Mayo score ≥ 2 predicts a lower likelihood of achieving complete response to first-line corticosteroids. Clinical features were not significant in predicting treatment outcomes. These findings suggest treatment strategies should incorporate endoscopic findings to optimize management strategies.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Visschedijk, M.C. and Haan, J.J. de and Bouwknegt, D.G. |
| Faculty: | Medical Sciences |
| Date Deposited: | 23 Mar 2026 14:16 |
| Last Modified: | 23 Mar 2026 14:16 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3906 |
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