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Immune-Related Adverse Events for GI Toxicity - Colitis
CTCAE-based grading of diarrhea/colitis from immune checkpoint inhibitor therapy.
Immune-Related Adverse Events for GI Toxicity - Colitis
Clinical presentation
ResultGrade 1
May continue immunotherapy with close monitoring and symptomatic treatment; rule out infection if diarrhea persists.
- CTCAE grade
- 1
When to use
- Grading severity of diarrhea/colitis in a patient on immune checkpoint inhibitor therapy to guide whether to hold therapy and start immunosuppression.
Formula
Graded by increase in stool frequency over the patient's own baseline plus associated features (pain, bleeding, incontinence, hospitalization, life-threatening complications), per CTCAE. Not an additive score — grade is assigned by the highest applicable criterion.
Pearls and pitfalls
- Infectious colitis (including C. difficile) must be excluded before attributing diarrhea to checkpoint inhibitor toxicity.
- Endoscopic and histologic findings can be more severe than the clinical grade suggests and may support earlier escalation.