Immune checkpoint inhibitor-mediated colitis is associated with cancer overall survival

BACKGROUND Immune checkpoint inhibitor-mediated colitis(IMC)is a common adverse event following immune checkpoint inhibitor(ICI)therapy for cancer.IMC has been associated with improved overall survival(OS)and progression-free survival(PFS),but data are limited to a single site and predominantly for melanoma patients.AIM To determine the association of IMC with OS and PFS and identify clinical predictors of IMC.METHODS We performed a retrospective case-control study including 64 ICI users who developed IMC matched according to age,sex,ICI class,and malignancy to a cohort of ICI users without IMC,from May 2011 to May 2020.Using univariate and multivariate logistic regression,we determined association of presence of IMC on OS,PFS,and clinical predictors of IMC.Kaplan-Meier curves were gen-erated to compare OS and PFS between ICI users with and without IMC.RESULTS IMC was significantly associated with a higher OS(mean 24.3 mo vs 17.7 mo,P=0.05)but not PFS(mean 13.7 mo vs 11.9 mo,P=0.524).IMC was significantly associated with OS greater than 12 mo[Odds ratio(OR)2.81,95%confidence interval(CI)1.17-6.77].Vitamin D supplementation was significantly associated with increased risk of IMC(OR 2.48,95%CI 1.01-6.07).CONCLUSION IMC was significantly associated with OS greater than 12 mo.In contrast to prior work,we found that vitamin D use may be a risk factor for IMC.