Aim: Autoimmune colitis is a typical and possible severe side effect among patients treated with ipilimumab. Patients & methods: We prospectively included 100 patients with metastasized melanoma under ipilimumab treatment in a radiological study of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT). PET evidence of pancolitis (‘PET-colitis’) was correlated with clinical variables. Results: We observed a significant correlation between PET-colitis and clinically significant diarrhoea, although PET-colitis was more frequent (49 vs 29% of patients, respectively). Neither PET-colitis nor diarrhoea was significantly correlated with response to therapy. Other immune-related adverse events, however, such as hypophysitis and hepatitis were associated with response to therapy and overall survival. Conclusion: Increased 18F-FDG uptake in the colon correlated with clinical symptoms but did not predict clinical outcome to ipilimumab.

Summary Background Photodynamic therapy (PDT) is an effective therapy treating photodamaged areas with multiple actinic keratoses (AK). Still pain during therapy is one of the most challenging obstacles for patients. This retrospective study compares pain and efficacy intra‐individual in patients using conventional PDT (c‐PDT) compared to a low irradiance PDT protocol (li‐PDT) with a reduced irradiance to 25% of c‐PDT. Methods Thirty‐one patients were enrolled into this retrospective analysis treated with li‐PDT and c‐PDT on comparable fields of actinic damage on the forehead or the cheek. Pain was scored by the patients using a VAS. Moreover, number and time to therapy interruptions were documented. For effectiveness number and grade of AK were counted before and 4 weeks after PDT. Results Maintaining a total light dose of 37 J/cm2, a decrease in irradiation in li‐PDT patients resulted in significant less pain (VAS score 2.8 vs 7.6) and fewer therapy interruptions compared to treatment with c‐ PDT (P < 0.0005). No significant difference in treatment outcome was found (P = 0.068). Conclusion Our data shows that li‐PDT can reduce pain with at least comparable clinical outcome compared to c‐PDT. Therefore, it is an effective and well‐tolerated treatment for patients with multiple AK.

Changes in LDH level and side effects correlate with response to therapy and survival.