Evidence map›Paper›PMID 38296594›Full record

ArticleJournal for immunotherapy of cancer2024

Management of infliximab refractory immune checkpoint inhibitor gastrointestinal toxicity: a multicenter case series.

Catriona Harvey, Kazi J Nahar, Janet McKeown, Serigne N Lo, Sheima Farag, Nadia Yousaf, Kate Young, Liselotte Tas, Aafke Meerveld-Eggink, Christian Blank and 12 more

Open access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal for immunotherapy of cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.8field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 10 citations in OpenAlex.

  1. The Immune Checkpoint Inhibitors Journey: From Early Promise to Lasting Impact.Journal of immunotherapy and precision oncology · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors at 12 institutions in 6 countries.

Catriona HarveyWestmead Hospital WNH, Westmead, New South Wales, Australia.ORCID 0000-0002-4762-8925
Kazi J NaharMelanoma Institute Australia, North Sydney, New South Wales, Australia.
Janet McKeownMelanoma Institute Australia, North Sydney, New South Wales, Australia.
Serigne N LoResearch and Biostatistics Group, Melanoma Institute Australia, North Sydney, New South Wales, Australia.ORCID 0000-0001-5092-5544
Sheima FaragRoyal Marsden Hospital NHS Trust, London, UK.
Nadia YousafRoyal Marsden Hospital NHS Trust, London, UK.
Kate YoungRoyal Marsden Hospital NHS Trust, London, UK.
Liselotte TasNetherlands Cancer Institute, Amsterdam, The Netherlands.
Aafke Meerveld-EgginkNetherlands Cancer Institute, Amsterdam, The Netherlands.
Christian BlankNetherlands Cancer Institute, Amsterdam, The Netherlands.
Austin ThomasThe University of Texas Health Science Center at Houston, Houston, Texas, USA.
Jennifer McQuadeUniversity of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Bastian SchillingUniversitatsklinikum Wurzburg, Würzburg, Germany.ORCID 0000-0001-8859-4103
Douglas B JohnsonVanderbilt University Medical Center, Nashville, Tennessee, USA.
Roberto Martín HuertasHospital Clinic de Barcelona, Barcelona, Spain.
Ana AranceHospital Clinic and Institut D'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
Joanna LeeThe University of Sydney, Sydney, New South Wales, Australia.
Lisa ZimmerDermatology, University Hospital Essen, Essen, Germany.ORCID 0000-0002-3680-3521
Georgina V LongMelanoma Institute Australia, Wollstonecraft, New South Wales, Australia.
Matteo S CarlinoWestmead Hospital WNH, Westmead, New South Wales, Australia.
Yinghong WangGastroenterology, Hepatology & Nutrition, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID 0000-0002-5148-6130
Alexander Maxwell MenziesMelanoma Institute Australia, North Sydney, New South Wales, Australia alexander.menzies@sydney.edu.au.
The University of Sydney · AURoyal Marsden Hospital · GBThe Netherlands Cancer Institute · NLThe University of Texas MD Anderson Cancer Center · USWestmead Hospital · AUConsorci Institut D'Investigacions Biomediques August Pi I Sunyer · ESEssen University Hospital · DEHospital Clínic de Barcelona · ESMelanoma Institute Australia · AUThe University of Texas Health Science Center at Houston · USUniversitätsklinikum Würzburg · DEVanderbilt University Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmune checkpoint inhibitor (ICI) gastrointestinal toxicity (gastritis, enteritis, colitis) is a major cause of morbidity and treatment-related death. Guidelines agree steroid-refractory cases warrant infliximab, however best management of infliximab-refractory ICI gastrointestinal toxicity (IRIGItox) is unknown.

methodsWe conducted an international multicenter retrospective case series. IRIGItox was defined as failure of symptom resolution ≤grade 1 (Common Terminology Criteria for Adverse Events V.5.0) following ≥2 infliximab doses

results78 patients were identified: median age 60 years; 56% men; majority melanoma (N=70, 90%); 60 (77%) received anti-cytotoxic T-lymphocyte-associated protein 4 alone or in combination with anti-programmed cell death protein-1 and most had colitis (N=74, 95%). 106 post-infliximab treatments were given: 31 calcineurin inhibitors (CNIs); 27 antimetabolites (mycophenolate, azathioprine); 16 non-systemic immunomodulatory agents (eg, mesalazine or budesonide); 15 vedolizumab; 5 other biologics (anti-interleukin-12/23, 16, Janus kinase inhibitors) and 7 interventional procedures (including colectomy); 5 did not receive post-infliximab therapy. Symptom resolution was achieved in most (N=23/31, 74%) patients treated with CNIs; 12/27 (44%) with antimetabolites; 7/16 (44%) with non-systemic immunomodulation, 8/15 (53%) with vedolizumab and 5/7 (71%) with interventional procedures. No non-vedolizumab biologics resulted in toxicity resolution. CNIs had the shortest time to symptom resolution (12 days) and steroid wean (43 days); however, were associated with poorer event-free survival (6.3 months) and overall survival (26.8 months) than other agents. Conversely, vedolizumab had the longest time to toxicity resolution and steroid wean, 66 and 124 days, but most favorable survival data: EFS 24.5 months; median OS not reached. Six death occurred (three due to IRIGItox or management of toxicity; three with persisting IRIGItox

conclusionsIRIGItox causes major morbidity and mortality. Management is heterogeneous. CNIs appear most likely to result in toxicity resolution in the shortest time period, however, are associated with poorer oncological outcomes in contrast to vedolizumab.

Indexed as

Biological ProductsColitisAntimetabolitesFemaleHumansImmune Checkpoint InhibitorsInfliximabMaleMiddle AgedRetrospective StudiesSteroidsAntimetabolitesBiological ProductsImmune Checkpoint InhibitorsInfliximabSteroidsCTLA-4 AntigenImmune Checkpoint InhibitorsImmunotherapyIpilimumabProgrammed Cell Death 1 Receptor

Identifiers

PMID38296594
PMCPMC10831444
OpenAlexW4391383584

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.