Patient characteristics, ICI treatment history, symptomatology, and endoscopy findings

PatientAgeSexMalignancyHistory of other ICI exposureICI type and doseDays (doses) to onset of symptoms post ICIDiarrhea gradeOther symptomsColitis gradeEndoscopic featuresHistopathologic features
175MMeningiomaNonePembrolizumabDose: 3 mg/kgFrequency: every 3 weeks39 days (2)1None2Colonoscopy:Sigmoid colon: localized moderate inflammation characterized by altered vascularity, congestion (edema), friability and granularityColonoscopy:- Ileum: mucosa with hyperplastic Peyer’s patches and no diagnostic abnormality- Ascending colon: mucosa with lymphoid aggregate and no diagnostic abnormality- Sigmoid colon: moderately active colitis with neutrophilic cryptitis and crypt abscesses
258FColon- Pembrolizumab (stopped 2 years prior to current ICI): no adverse effects but disease progressionIpilimumab/NivolumabDose:Ipilimumab-1 mg/kg, Nivolumab- 240 mg (3 mg/kg)Frequency: combined every 6 weeks (4 doses total) followed by nivolumab alone every 2 weeks8 days (1)2Abdominal pain2Upper endoscopy:- Gastric antrum: diffuse moderately erythematous mucosa without bleeding- Duodenum: an acquired benign-appearing, intrinsic moderate stenosis in the first portion of the duodenumUpper endoscopy:- Gastric antrum/fundus/body:active chronic gastritis- Duodenum: mucosa with ulceration, crypt dropout, marked expansion of lamina propria with prominent eosinophils and acute inflammation- Duodenal stricture: mucosa with mild expansion of the lamina propria
370FMelanoma- PD-L1 inhibitor (as a part of a clinical trial): for a total of 1 year (stopped 3 years prior to current ICI). No adverse events but disease recurrence- Pembrolizumab: 200 mg 3 (mg/kg) every 3 weeks for total of 8 doses (stopped 1 year prior to current ICI): no adverse events but disease progressionIpilimumabDose: 3 mg/kgFrequency: every 3 weeks35 days (2)2Nausea, vomiting2Upper Endoscopy:- Stomach: normal- Duodenum: diffuse moderately scalloped mucosaFlexible Sigmoidoscopy:- Colon: examined portion was normalUpper Endoscopy:- Duodenum: diffuse active duodenitis with villous blunting, expansion of the lamina propria with mixed inflammation, and reactive epithelial changes- Stomach: antral mucosa with edema and mild patchy inflammationFlexible Sigmoidoscopy:- Colon: normal
473MMelanomaAtezolizumab (in combination with cobimetinib): total of 13 cycles (stopped 2 weeks prior to current ICI)Ipilimumab/NivolumabDose:Ipilimumab-3 mg/kg, Nivolumab-1 mg/kgFrequency: combined every 3 weeks11 days (1)2Nausea, vomiting, abdominal pain2Upper Endoscopy:- Stomach: non-bleeding erosive gastropathy- Duodenum: diffuse mildly congested mucosa without active bleedingColonoscopy:- Sigmoid and descending colon: discontinuous areas of nonbleeding ulcerated mucosa with no stigmata of recent bleedingUpper Endoscopy:- Stomach: active gastritis with small stromal granuloma in antrum. Active gastritis with stromal histiocytes in the body- Duodenum: active duodenitis with villous injuryColonoscopy:- Descending colon: focal active colitis with stromal histiocytes- Colon and sigmoid ulcers: severely active colitis with ulceration
579FSCCNoneCemiplimabDose: 350 mgFrequency: every 3 weeks14 (1 dose)1Nausea, vomiting2Upper Endoscopy:- Stomach: Non-bleeding erosive gastropathy- Duodenum: normalFlexible Sigmoidoscopy:- Colon: Inflammation characterized by congestion (edema), erythema and granularityUpper Endoscopy:- Stomach: reactive gastropathy and intestinal metaplasia- Duodenum: normalFlexible Sigmoidoscopy:- Colon: mucosa with mildly increased cellularity of the lamina propria and epithelial injury. Focal acute inflammation is also noted, but there is no increase in apoptosis.