The entire intestinal tract surveillance using capsule endoscopy after immune checkpoint inhibitor administration: A prospective observational study

Keitaro Shimozaki, Kenro Hirata, Sara Horie, Akihiko Chida, Kai Tsugaru, Yukie Hayashi, Kenta Kawasaki, Ryoichi Miyanaga, Hideyuki Hayashi, Ryuichi Mizuno, Takeru Funakoshi, Naoki Hosoe, Yasuo Hamamoto, Takanori Kanai

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Despite the proven efficacy of immune checkpoint inhibitors (ICIs) against various types of malignancies, they have been found to induce immune-related adverse events, such as enterocolitis; however, the clinical features of ICI-induced enterocolitis remain to be sufficiently elucidated, which is significant, considering the importance of early detection in the appropriate management and treatment of ICI-induced enterocolitis. Therefore, the current study aimed to determine the utility of capsule endoscopy as a screening tool for ICI-induced enterocolitis. Methods: This single-center, prospective, observational study was conducted on patients with malignancy who received any ICI between April 2016 and July 2020 at Keio University Hospital. Next, second-generation capsule endoscopy (CCE-2) was performed on day 60 after ICI initiation to explore the entire gastrointestinal tract. Results: Among the 30 patients enrolled herein, 23 underwent CCE-2. Accordingly, a total of 23 findings were observed in 14 (60.8%) patients at any portion of the gastrointestinal tract (7 patients in the colon, 4 patients in the small intestine, 2 patients in both the colon and the small intestine, and 1 patient in the stomach). After capsule endoscopy, 2 patients (8.7%) developed ICI-induced enterocolitis: both had significantly higher Capsule Scoring of Ulcerative Colitis than those who had not developed ICI-induced enterocolitis (p = 0.0455). No adverse events related to CCE-2 were observed. Conclusions: CCE-2 might be a safe and useful entire intestinal tract screening method for the early detection of ICI-induced enterocolitis in patients with malignancies.

Original languageEnglish
Article number543
JournalDiagnostics
Volume11
Issue number3
DOIs
Publication statusPublished - 2021 Mar

Keywords

  • Capsule endoscopy
  • Enterocolitis
  • Immune checkpoint inhibitors
  • Observational study
  • Prospective studies

ASJC Scopus subject areas

  • Clinical Biochemistry

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