Vedolizumab: a novel treatment for ipilimumab-induced colitis

Hsieh, Amy Hsin-Chieh; Ferman, Mutaz; Brown, Michael P.; Andrews, Jane M.

doi:10.1136/bcr-2016-216641

Cited by 45 publications

(32 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results corroborate a recent report on a single patient who had developed colitis secondary to ipilimumab therapy and was successfully treated with vedolizumab [29]. The patients selected for vedolizumab therapy in our retrospective study were either steroid-dependent and/or partially steroid refractory.…”

Section: Discussionsupporting

confidence: 91%

Vedolizumab treatment for immune checkpoint inhibitor-induced enterocolitis

Bergqvist

Hertervig

Gedeon

et al. 2017

Cancer Immunol Immunother

202

156

View full text Add to dashboard Cite

Immune checkpoint inhibitors (ICPI), such as ipilimumab [anti-cytotoxic T-lymphocyte antigen-4 (CTLA-4) antibody] and nivolumab or pembrolizumab [anti-programmed cell death protein-1 (PD-1) antibodies], improve survival in several cancer types. Since inhibition of CTLA-4 or PD-1 leads to non-selective activation of the immune system, immune-related adverse events (irAEs) are frequent. Enterocolitis is a common irAE, currently managed with corticosteroids and, if necessary, anti-tumor necrosis factor-α therapy. Such a regimen carries a risk of serious side-effects including infections, and may potentially imply impaired antitumor effects. Vedolizumab is an anti-integrin α4β7 antibody with gut-specific immunosuppressive effects, approved for Crohn’s disease and ulcerative colitis. We report a case series of seven patients with metastatic melanoma or lung cancer, treated with vedolizumab off-label for ipilimumab- or nivolumab-induced enterocolitis, from June 2014 through October 2016. Clinical, laboratory, endoscopic, and histologic data were analyzed. Patients initially received corticosteroids but were steroid-dependent and/or partially refractory. One patient was administered infliximab but was refractory. The median time from onset of enterocolitis to start of vedolizumab therapy was 79 days. Following vedolizumab therapy, all patients but one experienced steroid-free enterocolitis remission, with normalized fecal calprotectin. This was achieved after a median of 56 days from vedolizumab start, without any vedolizumab-related side-effects noted. The patient in whom vedolizumab was not successful, due to active ulcerative colitis, received vedolizumab prophylactically. This is the first case series to suggest that vedolizumab is an effective and well-tolerated therapeutic for steroid-dependent or partially refractory ICPI-induced enterocolitis. A larger prospective study to evaluate vedolizumab in this indication is warranted.

show abstract

Section: Discussionsupporting

confidence: 91%

Vedolizumab treatment for immune checkpoint inhibitor-induced enterocolitis

Bergqvist

Hertervig

Gedeon

et al. 2017

Cancer Immunol Immunother

202

156

View full text Add to dashboard Cite

show abstract

“…[149][150][151] Case series and reports have also documented successful treatment of ICI-mediated, steroid-dependent, or steroid-refractory enterocolitis with vedolizumab. 76,152 Vedolizumab may be effective in the setting of infliximabresistant inflammation of the small intestine and colon. 77…”

Section: Gi Toxicitymentioning

confidence: 99%

Management of Immunotherapy-Related Toxicities, Version 1.2019, NCCN Clinical Practice Guidelines in Oncology

Thompson

Schneider

Brahmer

et al. 2019

Journal of the National Comprehensive Cancer Network

455

332

View full text Add to dashboard Cite

The aim of the NCCN Guidelines for Management of Immunotherapy-Related Toxicities is to provide guidance on the management of immune-related adverse events resulting from cancer immunotherapy. The NCCN Management of Immunotherapy-Related Toxicities Panel is an interdisciplinary group of representatives from NCCN Member Institutions and ASCO, consisting of medical and hematologic oncologists with expertise in a wide array of disease sites, and experts from the fields of dermatology, gastroenterology, neuro-oncology, nephrology, emergency medicine, cardiology, oncology nursing, and patient advocacy. Several panel representatives are members of the Society for Immunotherapy of Cancer (SITC). The initial version of the NCCN Guidelines was designed in general alignment with recommendations published by ASCO and SITC. The content featured in this issue is an excerpt of the recommendations for managing toxicity related to immune checkpoint blockade and a review of existing evidence. For the full version of the NCCN Guidelines, including recommendations for managing toxicities related to chimeric antigen receptor T-cell therapy, visit NCCN.org.

show abstract

“…Vedolizumab is a humanized monoclonal IgG1 antibody against α4β7 integrin, approved for treatment of IBD. Some case reports suggest that vedolizumab may be an effective drug in steroid-refractory or steroid-dependent patients [24, 25]. A recent study with seven patients with mild to moderate, steroid-dependent or steroid-refractory ipilimumab-induced enterocolitis has revealed that six out of seven patients treated with vedolizumab achieve remission and no adverse events were reported [26].…”

Section: Managementmentioning

confidence: 99%

Management of Gastrointestinal Toxicity from Immune Checkpoint Inhibitor

Rocha

Sousa

Salgado

et al. 2018

GE Port J Gastroenterol

View full text Add to dashboard Cite

Immune checkpoint inhibitors have shown anti-tumour activity in cancers such as melanoma, renal cell carcinoma, non-small-cell lung cancer, urothelial carcinoma, colorectal cancer, and Hodgkin’s lymphoma. Though immune checkpoint inhibitors have revolutionized the treatment and prognosis of some advanced malignancies, they are also associated with a significant risk of immune-related adverse events. These adverse events can occur in any organ system, but gastrointestinal side effects are among the most commonly reported, with manifestations ranging from mild diarrhoea to severe colitis, sharing some features with inflammatory bowel disease. Anticipating a greater use of these drugs in the future, gastroenterologists should expect to be increasingly faced with gastrointestinal immune-related adverse events. Knowledge of these toxicities, as well as effective management algorithms, is essential to enable early diagnosis and treatment, decreasing morbidity and mortality. We reviewed the currently available literature on gastrointestinal toxicity induced by immune checkpoint inhibitors, namely the clinical features, diagnosis, and management.

show abstract

Vedolizumab: a novel treatment for ipilimumab-induced colitis

Cited by 45 publications

References 15 publications

Vedolizumab treatment for immune checkpoint inhibitor-induced enterocolitis

Vedolizumab treatment for immune checkpoint inhibitor-induced enterocolitis

Management of Immunotherapy-Related Toxicities, Version 1.2019, NCCN Clinical Practice Guidelines in Oncology

Management of Gastrointestinal Toxicity from Immune Checkpoint Inhibitor

Contact Info

Product

Resources

About