Vitamin D intake is associated with decreased risk of immune checkpoint inhibitor‐induced colitis
| Autor: | Michael Dougan, Elizabeth I. Buchbinder, Meredith Davis, Anita Giobbie-Hurder, William Martin-Doyle, Patrick A. Ott, Osama E. Rahma, Maria Gargano, F. Stephen Hodi, Shilpa Grover, Rawad Elias, Rizwan Haq, Taha Qazi, Kruti Vora, Steven M. Blum, Jeffrey J. Ishizuka, Kevin Tyan, Ryan J. Sullivan, Michael Manos, Lauren Eastman, Alex B. Ruan |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Neutrophils medicine.medical_treatment Programmed Cell Death 1 Receptor Logistic regression Gastroenterology Article 03 medical and health sciences Antineoplastic Agents Immunological 0302 clinical medicine Internal medicine Vitamin D and neurology medicine Humans CTLA-4 Antigen Lymphocytes 030212 general & internal medicine Vitamin D Colitis Immune Checkpoint Inhibitors Melanoma Aged business.industry Antibodies Monoclonal Cancer Immunotherapy Middle Aged medicine.disease Ulcerative colitis Oncology 030220 oncology & carcinogenesis Toxicity Cohort Female business |
| Zdroj: | Cancer |
| ISSN: | 1097-0142 0008-543X |
| DOI: | 10.1002/cncr.32966 |
| Popis: | Background There is a lack of predictive markers informing on the risk of colitis in patients treated with immune checkpoint inhibitors (ICIs). The aim of this study was to identify potential factors associated with development of ICI colitis. Methods We performed a retrospective analysis of melanoma patients at Dana-Farber Cancer Institute who received PD-1, CTLA-4, or combination ICIs between May 2011 to October 2017. Clinical and laboratory characteristics associated with pathologically confirmed ICI colitis were evaluated using multivariable logistic regression analyses. External confirmation was performed on an independent cohort from Massachusetts General Hospital. Results The discovery cohort included 213 patients of whom 37 developed ICI colitis (17%). Vitamin D use was recorded in 66/213 patients (31%) before starting ICIs. In multivariable regression analysis, vitamin D use conferred significantly reduced odds of developing ICI colitis (OR 0.35, 95% CI 0.1-0.9). These results were also demonstrated in the confirmatory cohort (OR 0.46, 95% CI 0.2-0.9) of 169 patients of whom 49 developed ICI colitis (29%). Pre-treatment neutrophil-to-lymphocyte ratio (NLR) ≥5 predicted reduced odds of colitis (OR 0.34, 95% CI 0.1-0.9) only in the discovery cohort. Conclusions This is the first study to report that among patients treated with ICIs, vitamin D intake is associated with reduced risk for ICI colitis. This finding is consistent with prior reports of prophylactic use of vitamin D in ulcerative colitis and graft-versus-host-disease. This observation should be validated prospectively in future studies. |
| Databáze: | OpenAIRE |
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