Evidence map›Paper›PMID 40785196›Full record

ArticleCancer medicine2025

Gastrointestinal Infection Before Immune Checkpoint Inhibition Hinders Treatment Efficacy and Increases the Risk of Colitis.

Malek Shatila, Kian Abdul-Baki, Andres Urias Rivera, Kei Takigawa, Irene Jeong-Ah Lee, Andrew Sullivan, Tanvi Gupta, Linfeng Lu, Raakhi Menon, Ayesha Khan and 14 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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

24 authors.

Malek ShatilaDepartment of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Kian Abdul-BakiDepartment of Internal Medicine, The University of Texas Medical Branch, Galveston, Texas, USA.
Andres Urias RiveraDepartment of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.ORCID https://orcid.org/0009-0007-9394-4236
Kei TakigawaDepartment of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.
Irene Jeong-Ah LeeDepartment of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.
Andrew SullivanDepartment of Internal Medicine, The University of Texas Health Sciences Center, Houston, Texas, USA.
Tanvi GuptaDepartment of Internal Medicine, The University of Texas Health Sciences Center, Houston, Texas, USA.
Linfeng LuDepartment of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.
Raakhi MenonDepartment of Internal Medicine, The University of Texas Medical Branch, Galveston, Texas, USA.
Ayesha KhanDepartment of Internal Medicine, The University of Texas Medical Branch, Galveston, Texas, USA.
Hamza SalimDepartment of Internal Medicine, Memorial Hermann Hospital, Houston, Texas, USA.
Elliot BaermanDepartment of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.
Carolina Colli CruzDepartment of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Cristina NathaDepartment of Internal Medicine, The University of Texas Health Sciences Center, Houston, Texas, USA.
Varun VemulapalliDepartment of Internal Medicine, The University of Texas Health Sciences Center, Houston, Texas, USA.
Garrett ColemanDepartment of Internal Medicine, The University of Texas Medical Branch, Galveston, Texas, USA.
Krishnavathana VaratharajaluDepartment of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Christopher FanDepartment of Gastroenterology, Houston Methodist Hospital, Houston, Texas, USA.
Pablo OkhuysenDepartment of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Anthony J OlszanskiDepartment of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
Yan ZhouDepartment of Hospital Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Hao Chi ZhangDepartment of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Mehnaz ShafiDepartment of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Yinghong WangDepartment of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID https://orcid.org/0000-0002-5148-6130

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGastrointestinal (GI) infections, which often result in or stem from intestinal dysbiosis, can affect the efficacy of immune checkpoint inhibitors (ICIs) and increase the risk of adverse effects, such as colitis. In this study, we explored the impact of GI infections before initiation of ICI therapy on the incidence and severity of immune-mediated colitis (IMC) and survival.

methodsA single-center, retrospective review including all patients who received ICIs from January 2010 to February 2024 and subsequently developed IMC. Patients were screened for IMC and prior GI infections based on symptoms and stool tests. Patients' demographic, IMC, and GI infection-related clinical data were collected.

resultsThirty-four of the 1132 patients (3.0%) included in the analysis had GI infections before ICI therapy. GI infections were most commonly caused by Clostridioides difficile and most often treated with oral antibiotics (interquartile range [IQR], 7-14 days). The incidence of IMC was higher in patients with prior GI infections compared to patients without prior infections (8.7% vs. 5.1%, p = 0.002). IMC symptoms, severity, and outcomes were similar in both groups (p > 0.05). In multivariate Cox proportional survival analysis, prior GI infection was independently associated with an increased risk of mortality (odds ratio, 1.6 [95% CI, 1.4-1.8]; p < 0.001) for patients who received ICIs.

conclusionsOur study is the first to explore the impact of GI infection before ICI therapy on IMC risk and survival. We found that prior GI infection was associated with an increased incidence of IMC and an increased risk of mortality in patients receiving ICIs.

Indexed as

ColitisGastrointestinal DiseasesImmune Checkpoint InhibitorsNeoplasmsAgedAged, 80 and overAnti-Bacterial AgentsFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesRisk FactorsTreatment OutcomeAnti-Bacterial AgentsImmune Checkpoint Inhibitorsgastrointestinal infectionsgut microbiomeimmune checkpoint inhibitorsimmune‐mediated colitisintestinal dysbiosisrisk factorsselective immunosuppressive therapy

Identifiers

PMID40785196
PMCPMC12336284

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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.