Scholarlink

Introduction <p>Immune checkpoint inhibitors (ICIs) have transformed cancer therapy but are frequently associated with immune-mediated colitis (IMC), a potentially severe complication. However, evidence on treatment effectiveness and predictors of response is limited.</p> Materials and Methods <p>We conducted a multicenter, retrospective study promoted by GETECCU including adult patients with solid tumors who developed grade 3–4 IMC requiring hospitalization between 2014 and 2024. All patients received intravenous corticosteroids; those refractory to steroids could receive targeted therapies. Clinical symptoms were assessed using a modified partial Mayo score including abdominal pain, and endoscopic activity was evaluated with the UCEIS index. Treatment failure was defined as the need for rescue therapy, surgery, or death.</p> Results <p>We included 211 patients (40% women, mean age 62&#xa0;years). Corticosteroid response was achieved in 50.2% of cases. Non-responders had shorter time to IMC onset, prior outpatient steroid use, higher symptom severity, and more frequent moderate-to-severe endoscopic findings. Independent predictors of corticosteroid failure were prior oral corticosteroid use (OR 4.4), higher UCEIS score (OR 1.31), and higher modified Mayo score (OR 1.45). A total of 113 rescue therapies were administered, primarily infliximab, vedolizumab, or ustekinumab, with overall effectiveness rates of 65–72%. Clinical severity was the only factor associated with reduced response to rescue therapy.</p> Conclusion <p>Corticosteroid efficacy in severe IMC is limited. Clinical symptom severity and endoscopic ulcerations predict poor response to corticosteroids, while symptom severity also influences outcomes of biologic rescue therapy. Early identification of high-risk patients may improve treatment strategies.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Predictors of Steroid Failure and Outcomes of Rescue Therapy in Severe ICI-Induced Colitis: A Multicenter Study from GETECCU

  • 期刊论文

  • 发表日期：

    2026年7月29日

查看全文
  • Cristina Polo Cuadro,
  • Marta Gascón Ruiz,
  • Manuel Barreiro,
  • Míriam Mañosa,
  • Francisco Rodríguez Moranta,
  • Yamile Zabana,
  • Elena Céspedes Martínez,
  • Ingrid Ordás,
  • José Miranda Bautista,
  • María José García,
  • Irene García de la Filia Molina,
  • Cristina Roig Ramos,
  • Alexandra Ruiz Cerulla,
  • José Xavier Segarra Ortega,
  • Virginia Matallana Royo,
  • G. Esther Rodríguez González,
  • Fernando Martínez de Juan,
  • Noemí Manceñido Marcos,
  • Lucía Madero Velázquez,
  • Elena Betoré Glaría,
  • Begoña Álvarez Herrero,
  • Gerard Suris,
  • Alejandro Garrido Marín,
  • Eduard Brunet Mas,
  • Inmaculada Alonso Abreu,
  • Javier Santos Fernández,
  • María Vaamonde Lorenzo,
  • Cristina Almingol Crespo,
  • Carla Folguera,
  • Patricia Sanz Segura,
  • Óscar Moralejo Lozano,
  • Laura López Couceiro,
  • Coral Tejido Sandoval,
  • Raquel Mena Sánchez,
  • Empar Sainz,
  • Miquel Marquès Camí,
  • Rocío Ferreiro Iglesias,
  • Silvia Patricia Ortega Moya,
  • Pablo Miles Wolfe García,
  • Pere Borras Garriga,
  • Belén Herreros Martínez,
  • María Calvo,
  • Santiago Frago Larramona,
  • Pablo Ladrón Abia,
  • Carla J. Gargallo Puyuelo,
  • Xavier Serra,
  • Luis Menchén,
  • Coral Rivas,
  • Francisco Mesonero Gismero,
  • Raquel Vicente Lidón,
  • Ana Gutierrez,
  • Santiago García López,
  • Diego Casas Deza

摘要

Introduction

Immune checkpoint inhibitors (ICIs) have transformed cancer therapy but are frequently associated with immune-mediated colitis (IMC), a potentially severe complication. However, evidence on treatment effectiveness and predictors of response is limited.

Materials and Methods

We conducted a multicenter, retrospective study promoted by GETECCU including adult patients with solid tumors who developed grade 3–4 IMC requiring hospitalization between 2014 and 2024. All patients received intravenous corticosteroids; those refractory to steroids could receive targeted therapies. Clinical symptoms were assessed using a modified partial Mayo score including abdominal pain, and endoscopic activity was evaluated with the UCEIS index. Treatment failure was defined as the need for rescue therapy, surgery, or death.

Results

We included 211 patients (40% women, mean age 62 years). Corticosteroid response was achieved in 50.2% of cases. Non-responders had shorter time to IMC onset, prior outpatient steroid use, higher symptom severity, and more frequent moderate-to-severe endoscopic findings. Independent predictors of corticosteroid failure were prior oral corticosteroid use (OR 4.4), higher UCEIS score (OR 1.31), and higher modified Mayo score (OR 1.45). A total of 113 rescue therapies were administered, primarily infliximab, vedolizumab, or ustekinumab, with overall effectiveness rates of 65–72%. Clinical severity was the only factor associated with reduced response to rescue therapy.

Conclusion

Corticosteroid efficacy in severe IMC is limited. Clinical symptom severity and endoscopic ulcerations predict poor response to corticosteroids, while symptom severity also influences outcomes of biologic rescue therapy. Early identification of high-risk patients may improve treatment strategies.