1 | 75 | M | Meningioma | None | PembrolizumabDose: 3 mg/kgFrequency: every 3 weeks | 39 days (2) | 1 | None | 2 | Colonoscopy:Sigmoid colon: localized moderate inflammation characterized by altered vascularity, congestion (edema), friability and granularity | Colonoscopy:- 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 |
2 | 58 | F | Colon | - Pembrolizumab (stopped 2 years prior to current ICI): no adverse effects but disease progression | Ipilimumab/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 weeks | 8 days (1) | 2 | Abdominal pain | 2 | Upper endoscopy:- Gastric antrum: diffuse moderately erythematous mucosa without bleeding- Duodenum: an acquired benign-appearing, intrinsic moderate stenosis in the first portion of the duodenum | Upper 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 |
3 | 70 | F | Melanoma | - 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 progression | IpilimumabDose: 3 mg/kgFrequency: every 3 weeks | 35 days (2) | 2 | Nausea, vomiting | 2 | Upper Endoscopy:- Stomach: normal- Duodenum: diffuse moderately scalloped mucosaFlexible Sigmoidoscopy:- Colon: examined portion was normal | Upper 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 |
4 | 73 | M | Melanoma | Atezolizumab (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 weeks | 11 days (1) | 2 | Nausea, vomiting, abdominal pain | 2 | Upper 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 bleeding | Upper 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 |
5 | 79 | F | SCC | None | CemiplimabDose: 350 mgFrequency: every 3 weeks | 14 (1 dose) | 1 | Nausea, vomiting | 2 | Upper Endoscopy:- Stomach: Non-bleeding erosive gastropathy- Duodenum: normalFlexible Sigmoidoscopy:- Colon: Inflammation characterized by congestion (edema), erythema and granularity | Upper 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. |