Vedolizumab Attenuates Immune-Checkpoint-Therapy-Induced Infliximab-Refractory Colitis

Abstract

Immune checkpoint inhibitors (ICIs), such as nivolumab and ipilimumab, have drastically changed treatments of advanced melanoma. However, ICI-related enterocolitis is often the most common adverse event, and represents the main reason for ICI discontinuation and mortalities. Here, we report the case of a metastatic melanoma treated with vedolizumab for ICI-induced colitis. A 67-year-old man treated with ipilimumab and nivolumab developed ICI-induced colitis and grade 3 diarrhea refractory to methylprednisolone and infliximab. After his third dose of vedolizumab, oral prednisolone ceased, and the colitis had completely resolved with no recurrence. This case report supports vedolizumab use in treating severe colitis which failed to resolve with first- and second-line immunosuppressive therapy.

Immune checkpoint inhibitor induced colitis and arthritis: A case report

“…[ 10 ] In addition, the NCCN (National Comprehensive Cancer Network) guidelines also mention that vedolizumab may be considered if infliximab is ineffective or contraindicated. [ 11 , 12 ]…”

Check this out: treatment paradigms in immune-checkpoint inhibitor colitis

“…As far as recurrence of colitis, the vedolizumab group also had lower rates compared with the infliximab group. Important to note, vedolizumab is a gut-specific agent and is not known to help treat any other nongastrointestinal-related irAEs [28 ▪▪ ,29].…”

Prevention of severe immune‐related colitis caused by combined immune checkpoint inhibition using vedolizumab: A case report

“…7 In previously published cases, the benefit of vedolizumab in patients with severe immune-mediated colitis has been reported. 8,9 Our case highlights that vedolizumab could be used to minimize the risk of recurrent immunotherapy-related colitis. A study with 14 patients reported similar results: The use of vedolizumab in patients with previous immunotherapyrelated colitis after CPI lowered the rate of recurrent colitis in this small cohort (12% vs. 50%).…”