The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Content within the patient forum is user-generated and has not been reviewed by medical professionals. Other sections of the Melanoma Research Foundation website include information that has been reviewed by medical professionals as appropriate. All medical decisions should be made in consultation with your doctor or other qualified medical professional.

Ipi Nivo colitis

Forums General Melanoma Community Ipi Nivo colitis

  • Post
    tim brown
      In mid July I had  my first Ipi/Nivo infusion but had to stop due to surgery to remove a rapidly  growing tumour in my axilla at the start of August. (I have the NRAS mutation). I’m restarting in a couple of weeks time and if the first infusion was anything to go by, then  diarrhea/colitis is likely to be my principal adverse event.
      Any advice on diet and lifestyle that has helped others would be  greatly appreciated.
    Viewing 3 reply threads
    • Replies
          I would personally remove all dairy and processed foods but I’m sure that’s not very helpful. Walking is good. Drinking lots of water will move things along in the gut. No narcotics will keep peristalsis going. maybe increasing good gut bacteria (probiotics) but I seem to remember a study indicating weird (both positive and negative?) issues with probiotics and immunotherapy…
            ed williams
              Kathy and Tim, just wanted to share some MD Anderson stuff from a couple of years ago, where Dr. Michael Davies shared research from their hospital. If you go to the 23:00 min mark he talks about diet and probiotics.
            tim brown
              Thanks Kathy and Ed,

              I had a vague memory that probiotics wasn’t recommended but I’ll watch Dr Davies

                Hey Tim,

                I will be keeping my fingers crossed that all things go well when you resume treatment!!!  Here are a few reports that may interest you – more related to response and the microbiome than preventing colitis – but still…

                This has lots of links within:  The gut microbiome AGAIN – as it relates to immunotherapy for melanoma, other cancers, antibiotic use, and fecal transplants! ~

                This article notes that probiotics from the bottle don’t serve us as well as those attained from natural sources like yogurt, kimchi, sauerkraut, etc – and that making sure to include high fiber foods is key to a good response:


                And while I am hoping colitis will not be a significant problem for you, there is this:

                Association of Chronic Immune-Mediated Diarrhea and Colitis With Favorable Cancer Response. Zou, Abu-Sbeih, Ma, et al. J Natl Compr Canc Netw. Dec 2020.

                Background: Immune-mediated diarrhea and colitis (IMDC) is a common immune-related adverse effect related to immune checkpoint inhibitors. We aimed to identify risk factors for chronic IMDC and its prognostic value in cancer outcomes.

                Methods: We retrospectively collected data on patients with a diagnosis of IMDC between January 2018 and October 2019 and grouped them based on disease duration into acute (less than or equal to 3 months) and chronic (greater than 3 months) categories. A logistic regression model and the Kaplan-Meier method with log-rank tests were used for biostatistical analysis.

                Results: In our sample of 88 patients, 43 were in the chronic group and 45 were in the acute group. Genitourinary cancer and melanoma accounted for 70% of malignancies. PD-1/L1 monotherapy (52%) was the more frequently used regimen. We showed that chronic IMDC was associated with proton pump inhibitor use, long duration of IMDC symptoms and hospitalization, a histologic feature of chronic active colitis or microscopic colitis, and delayed introduction of selective immunosuppressive therapy (infliximab/vedolizumab). Chronic IMDC also reflected a better cancer response to immune checkpoint inhibitors (30% vs 51%) and was accompanied by improved overall survival. Similarly, higher doses of selective immunosuppressive therapy were associated with better overall survival.

                Conclusions: Chronic IMDC can develop among patients with a more aggressive disease course and chronic features on colon histology. It likely reflects a prolonged immune checkpoint inhibitor effect and is associated with better cancer outcome and overall survival.

                <hr />

                Hang in there!!  Celeste


                    I spent much of yesterday going through the AIM videos. THank you SO MUCH for those!!!!
                    I just want to say that when my colitis hits, which it has both times I had ippy in the treatment, there is no amount of dietary or other control to stop or mitigate the diarreah. The first time was 6 weeks in hospital, the second was reduced doseage and we were able to avoid a hospital situation with outpatient fluids. Still, one and done for the ippi. Just a data point, hope yours in more manageable. Sometimes it is just Not.

                    Now on Optivo Maintenence. I am also NRAS+ and am hoping to be part of that profile mentioned in the research by Bubbles.

                    Congratulations on your very aggressive cancer and horrible side effects, looks like things might be looking up!

                Viewing 3 reply threads
                • You must be logged in to reply to this topic.
                About the MRF Patient Forum

                The MRF Patient Forum is the oldest and largest online community of people affected by melanoma. It is designed to provide peer support and information to caregivers, patients, family and friends. There is no better place to discuss different parts of your journey with this cancer and find the friends and support resources to make that journey more bearable.

                The information on the forum is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.

                Popular Topics