ArticleJournal for immunotherapy of cancer2022
Oral beclomethasone dipropionate is an effective treatment for immune checkpoint inhibitor induced colitis.
Article in Journal for immunotherapy of cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 9 citations in OpenAlex.
- Management of gastrointestinal adverse effects in immune-based combination therapy for advanced renal carcinoma: when the oncologist meets the gastroenterologist.Therapeutic advances in gastroenterology · 2025Review
- Endoscopic findings of immune checkpoint inhibitor-related gastrointestinal adverse events.Clinical endoscopy · 2024Review
- Updates in the pathogenesis and management of immune-related enterocolitis, hepatitis and cardiovascular toxicities.Immuno-oncology technology · 2024Review
- Treating the Side Effects of Exogenous Glucocorticoids; Can We Separate the Good From the Bad?Endocrine reviews · 2023Review
- Checkpoint Inhibitor-Induced Colitis: From Pathogenesis to Management.International journal of molecular sciences · 2023Review
- Immune-related adverse events in checkpoint blockade: Observations from human tissue and therapeutic considerations.Frontiers in immunology · 2023Review
- Identification of natural product 3, 5-diiodotyrosine as APOBEC3B inhibitor to prevent somatic mutation accumulation and cancer progression.Journal for immunotherapy of cancer · 2022Article
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Authors and funding
15 authors at 4 institutions in 1 country.
Funding
Abstract
introductionSystemic corticosteroids are the mainstay of treatment for immune checkpoint inhibitor induced (CPI) colitis but are associated with complications including life-threatening infection. The topically acting oral corticosteroid beclomethasone dipropionate (BD) is an effective treatment for mild to moderate flares of ulcerative colitis, and has fewer side effects than systemic corticosteroids. We hypothesized that BD would be an effective treatment for CPI-induced colitis.
methodsWe performed a retrospective analysis of all patients who started BD for CPI-induced colitis at three UK cancer centers between November 2017 and October 2020. All patients underwent endoscopic assessment and biopsy. The initial regimen of BD was 5 mg once daily for 28 days. Data were collected from electronic patient records. Clinical outcomes were assessed at 28 days after initiation of treatment.
resultsTwenty-two patients (14 male) with a median age of 64 (range 45-84) with CPI-induced colitis were treated with BD. At baseline, the median number of loose stools in a 24-hour period was six (common terminology criteria for adverse events, CTCAE grade diarrhea=2). Thirteen patients (59%) were dependent on systemic corticosteroids prior to starting BD. Baseline sigmoidoscopy showed moderate inflammation (Mayo Endoscopic Score (MES) = 2) in two patients (9%), mild inflammation (MES=1) in nine patients (41%) and normal findings (MES=0) in eleven patients (50%). Twenty patients (91%) had histopathological features of inflammation. All 22 patients (100%) had a clinical response to BD and 21 (95%) achieved clinical remission with a return to baseline stool frequency (CTCAE diarrhea=0). Ten patients (45%) had symptomatic relapse on cessation of BD, half within 7 days of stopping. All patients recaptured response on restarting BD. No adverse events were reported in patients treated with BD.
conclusionsTopical BD represents an appealing alternative option to systemic immunosuppressive treatments to treat colonic inflammation. In this study, BD was effective and safe at inducing remission in CPI-induced colitis, which was refractory to systemic corticosteroids. Further randomized studies are needed to confirm these findings and determine the optimum dosing regimen.
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