A109 CHECKPOINT INHIBITOR-RELATED LYMPHOCYTIC COLITIS: A NEW, PATHOLOGICAL ENTITY
Pourquoi ce travail est dans la base
Une base qui oublie comment elle a trouvé un travail ne peut pas être vérifiée. Voici les voies qui ont admis celui-ci.
Notice bibliographique
Résumé
Checkpoint inhibitors, such as anti-cytotoxic-T-lymphocyte antigen-4 (anti-CTLA-4) and anti-programmed death-1 (anti-PD-1) are associated with significant gastrointestinal (GI) toxicity such as diarrhea and colitis. We report a unique case of anti-PD1 induced lymphocytic colitis (LC). We also systematically review the current literature on this rare pathological entity. A systematic search of electronic databases was performed through August 2018 for all studies assessing diarrhea and colitis secondary to anti-CTLA4 and/or anti-PD1 use. Case-studies, case-series, and observational studies reporting immune-related microscopic colitis were included in the study. Case Report: 65F, with stage IV non-small cell lung cancer, was started on nivolumab therapy after progression on curative-intent chemoradiation therapy. Eight months later, despite disease improvement, she endorsed 4 watery bowel movements (BMs) per day without pain or blood. Nivolumab was held and a 2-week course of oral prednisone (1mg/kg) resulted in complete resolution of symptoms. Nivolumab was then re-started but she experienced an increase in BMs to 5–6/day. A 4-week taper of oral prednisone (1mg/kg) and nivolumab discontinuation resulted in complete diarrhea resolution. Nivolumab was re-started but her diarrhea relapsed, and she was admitted to the hospital with severe symptoms (35+ BMs/day with abdominal pain). Colonoscopy was unremarkable, but biopsies demonstrated an increase in lamina propria plasma cells and intra-epithelial lymphocytes consistent with LC. Intravenous methylprednisolone (1 mg/kg) was given with partial response. She was then prescribed one dose of infliximab 5mg/kg with immediate resolution of symptoms. Nivolumab was not restarted given the significant morbidity. Systematic Review: Seven studies were included: 4 case studies (8 patients) and 3 full-length manuscripts (11 patients). Seventeen patients were diagnosed with LC and 2 with collagenous colitis. Patient demographic and treatment data was available for 8 patients. Three patients were treated with pembrolizumab, 2 with nivolumab, 2 with atezolizumab, and 1 with ipilimumab. Two patients had a history of bladder cancer, and 1 each had a history of breast, renal, prostate, melanoma, lung, and anal cancer. Colonoscopy was normal in 6 patients and abnormal in 2 patients (mild left-sided congestion). Seven patients received high dose oral or intravenous methylprednisolone, only 3 achieved complete resolution. Three patients required infliximab therapy (2–4 doses) and one required vedolizumab therapy (2 doses) with complete resolution. Finally, one patient received budesonide (9mg/day) for 12 weeks with complete resolution of symptoms. Immune-related lymphocytic colitis appears to follow an aggressive course and may require biologic therapy such as anti-TNF agents. None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle