Vedolizumab treatment for immune checkpoint inhibitor-induced enterocolitis

• DOI: 10.1007/s00262-017-1962-6
• Publication Date: 2017-02-15T14:08:01Z
• Authors: Viktoria Bergqvist; Erik Hertervig; Peter Gedeon; Marija Kopljar; Håkan Griph; Sara Kinhult; Ana Carneiro; Jan Marsal
• Keywords: Vedolizumab; Enterocolitis

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 PD-1 leads to non-selective activation 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 regimen carries risk serious side-effects including infections, may potentially imply impaired antitumor effects. Vedolizumab an anti-integrin α4β7 antibody gut-specific immunosuppressive effects, approved for Crohn's disease ulcerative colitis. We report case series seven patients metastatic melanoma lung cancer, treated vedolizumab off-label ipilimumab- nivolumab-induced enterocolitis, from June 2014 through October 2016. Clinical, laboratory, endoscopic, histologic data were analyzed. Patients initially received but steroid-dependent and/or partially refractory. One patient was administered infliximab The median time onset enterocolitis start therapy 79 days. Following therapy, all one experienced steroid-free remission, normalized fecal calprotectin. This achieved after 56 days start, without any vedolizumab-related noted. whom not successful, due active colitis, prophylactically. first suggest that effective well-tolerated therapeutic refractory ICPI-induced enterocolitis. A larger prospective study evaluate this indication warranted.