Clostridium difficile infection and immune ...
Document type :
Compte-rendu et recension critique d'ouvrage
Title :
Clostridium difficile infection and immune checkpoint inhibitor–induced colitis in melanoma: 18 cases and a review of the literature
Author(s) :
Vuillamy, Chloé [Auteur]
Service de dermatologie [CHU d'Amiens-Picardie]
Arnault, Jean-Philippe [Auteur]
Service de dermatologie [CHU d'Amiens-Picardie]
Fumery, Mathurin [Auteur]
Périnatalité et Risques Toxiques - UMR INERIS_I 1 [PERITOX]
Service d'Hépato Gastroenterologie [CHU Amiens-Picardie]
Mortier, Laurent [Auteur]
Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 [ONCO-THAI]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Monestier, Sandrine [Auteur]
Hôpital de la Timone [CHU - APHM] [TIMONE]
Mansard, Sandrine [Auteur]
CHU Estaing [Clermont-Ferrand]
Bens, Guido [Auteur]
Centre Hospitalier Régional d'Orléans [CHRO]
Duval-Modeste, Anne-Bénédicte [Auteur]
Hôpital Charles Nicolle [Rouen]
Funck-Brentano, Elisa [Auteur]
Hôpital Ambroise Paré [AP-HP]
Jeudy, Géraldine [Auteur]
CHU Dijon
Service de Dermatologie (CHU de Dijon)
Machet, Laurent [Auteur]
Imaging, Brain & Neuropsychiatry [iBraiN]
Chaby, Guillaume [Auteur]
Service de dermatologie [CHU d'Amiens-Picardie]
Dadban, Ali [Auteur]
Service de dermatologie [CHU d'Amiens-Picardie]
Lok, Catherine [Auteur]
Service de dermatologie [CHU d'Amiens-Picardie]
Service de dermatologie [CHU d'Amiens-Picardie]
Arnault, Jean-Philippe [Auteur]
Service de dermatologie [CHU d'Amiens-Picardie]
Fumery, Mathurin [Auteur]
![refId](/themes/Mirage2//images/idref.png)
Périnatalité et Risques Toxiques - UMR INERIS_I 1 [PERITOX]
Service d'Hépato Gastroenterologie [CHU Amiens-Picardie]
Mortier, Laurent [Auteur]
![refId](/themes/Mirage2//images/idref.png)
Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 [ONCO-THAI]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Monestier, Sandrine [Auteur]
Hôpital de la Timone [CHU - APHM] [TIMONE]
Mansard, Sandrine [Auteur]
CHU Estaing [Clermont-Ferrand]
Bens, Guido [Auteur]
Centre Hospitalier Régional d'Orléans [CHRO]
Duval-Modeste, Anne-Bénédicte [Auteur]
Hôpital Charles Nicolle [Rouen]
Funck-Brentano, Elisa [Auteur]
Hôpital Ambroise Paré [AP-HP]
Jeudy, Géraldine [Auteur]
CHU Dijon
Service de Dermatologie (CHU de Dijon)
Machet, Laurent [Auteur]
Imaging, Brain & Neuropsychiatry [iBraiN]
Chaby, Guillaume [Auteur]
Service de dermatologie [CHU d'Amiens-Picardie]
Dadban, Ali [Auteur]
Service de dermatologie [CHU d'Amiens-Picardie]
Lok, Catherine [Auteur]
Service de dermatologie [CHU d'Amiens-Picardie]
Journal title :
Melanoma Research
Publisher :
Lippincott, Williams & Wilkins
Publication date :
2023-03-27
ISSN :
0960-8931
HAL domain(s) :
Sciences du Vivant [q-bio]/Médecine humaine et pathologie
English abstract : [en]
Immunotherapy has become the standard of care for several types of cancer, such as melanoma. However, it can induce toxicity, including immune checkpoint inhibitor-induced colitis (CIC). CIC shares several clinical, ...
Show more >Immunotherapy has become the standard of care for several types of cancer, such as melanoma. However, it can induce toxicity, including immune checkpoint inhibitor-induced colitis (CIC). CIC shares several clinical, histological, biological, and therapeutic features with inflammatory bowel disease (IBD). Clostridium difficile infection (CDI) can complicate the evolution of IBD. We aimed to characterize the association between CDI and CIC in patients treated with anti-CTLA-4 and anti-PD-1 for melanoma. Patients from nine centers treated with anti-CTLA-4 and anti-PD-1 for melanoma and presenting with CDI from 2010 to 2021 were included in this retrospective cohort. The primary endpoint was the occurrence of CIC. The secondary endpoints were findings allowing us to characterize CDI. Eighteen patients were included. Eleven were treated with anti-PD-1, four with anti-CTLA-4, and three with anti-PD-1 in combination with anti-CTLA-4. Among the 18 patients, six had isolated CDI and 12 had CIC and CDI. Among these 12 patients, eight had CIC complicated by CDI, three had concurrent CIC and CDI, and one had CDI followed by CIC. CDI was fulminant in three patients. Endoscopic and histological features did not specifically differentiate CDI from CIC. Nine of 11 patients required immunosuppressive therapy when CDI was associated with CIC. In nine cases, immunotherapy was discontinued due to digestive toxicity. CDI can be isolated or can complicate or reveal CIC. CDI in patients treated with immunotherapy shares many characteristics with CDI complicating IBD. Stool tests for Clostridium difficile should be carried out for all patients with diarrhea who are being treated with immunotherapy.Show less >
Show more >Immunotherapy has become the standard of care for several types of cancer, such as melanoma. However, it can induce toxicity, including immune checkpoint inhibitor-induced colitis (CIC). CIC shares several clinical, histological, biological, and therapeutic features with inflammatory bowel disease (IBD). Clostridium difficile infection (CDI) can complicate the evolution of IBD. We aimed to characterize the association between CDI and CIC in patients treated with anti-CTLA-4 and anti-PD-1 for melanoma. Patients from nine centers treated with anti-CTLA-4 and anti-PD-1 for melanoma and presenting with CDI from 2010 to 2021 were included in this retrospective cohort. The primary endpoint was the occurrence of CIC. The secondary endpoints were findings allowing us to characterize CDI. Eighteen patients were included. Eleven were treated with anti-PD-1, four with anti-CTLA-4, and three with anti-PD-1 in combination with anti-CTLA-4. Among the 18 patients, six had isolated CDI and 12 had CIC and CDI. Among these 12 patients, eight had CIC complicated by CDI, three had concurrent CIC and CDI, and one had CDI followed by CIC. CDI was fulminant in three patients. Endoscopic and histological features did not specifically differentiate CDI from CIC. Nine of 11 patients required immunosuppressive therapy when CDI was associated with CIC. In nine cases, immunotherapy was discontinued due to digestive toxicity. CDI can be isolated or can complicate or reveal CIC. CDI in patients treated with immunotherapy shares many characteristics with CDI complicating IBD. Stool tests for Clostridium difficile should be carried out for all patients with diarrhea who are being treated with immunotherapy.Show less >
Language :
Anglais
Popular science :
Non
Source :
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