{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T14:34:09Z","timestamp":1778855649103,"version":"3.51.4"},"reference-count":51,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T00:00:00Z","timestamp":1562630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T00:00:00Z","timestamp":1562630400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitors (CPIs) have revolutionized oncologic therapy but can lead to immune\u2010related adverse events (irAEs). Corticosteroids are first\u2010line treatment with escalation to biologic immunosuppression in refractory cases. CPI\u2010related gastroenterocolitis (GEC) affects 20%\u201050% of patients receiving CPIs and can carry significant morbidity and mortality. Severe CPI\u2010related GEC is not well\u2010described. We present the clinical characterization of all CPI\u2010related GEC requiring admission at a single institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical, laboratory, radiographic, and endoscopic data were extracted from charts of all melanoma patients \u226518\u00a0years of age admitted to one institution for CPI\u2010related GEC, from February 5, 2011 to December 13, 2016. Patients were followed until December 31, 2017 for further admissions. Survival, outcomes, and pharmaceutical\u2010use analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median time\u2010to\u2010admission from initial CPI exposure was 73.5\u00a0days. Median length of stay was 4.5\u00a0days. About 50.0% required second\u2010line immunosuppression. Readmission for recrudescence occurred in 33.3%. Common Terminology Criteria for Adverse Events (CTCAE) grade was not significantly associated with outcomes. Hypoalbuminemia (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.005), relative lymphopenia (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.027), and decreased lactate dehydrogenase (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.026) were associated with second\u2010line immunosuppression. There was no difference in progression\u2010free survival (PFS) or OS (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.367, 0.400) for second\u2010line immunosuppression. Subgroup analysis showed that early corticosteroid administration (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.045) was associated with decreased PFS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Severe CPI\u2010related GEC typically manifests within 3\u00a0months of immunotherapy exposure. Rates of second\u2010line immunosuppression and readmission for recrudescence were high. CTCAE grade did not capture the degree of severity in our cohort. Second\u2010line immunosuppression was not associated with poorer oncologic outcomes; however, early corticosteroid exposure was associated with decreased PFS. Further investigation is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.2397","type":"journal-article","created":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T04:41:26Z","timestamp":1562647286000},"page":"4986-4999","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Colitis after checkpoint blockade: A retrospective cohort study of melanoma patients requiring admission for symptom control"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8042-5006","authenticated-orcid":false,"given":"Michael S.","family":"Hughes","sequence":"first","affiliation":[{"name":"Harvard Medical School Boston Massachusetts"},{"name":"Department of Medicine Massachusetts General Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Zheng","sequence":"additional","affiliation":[{"name":"Harvard Medical School Boston 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