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Kaneoka A, Okada E, Sugino H, Saito-Sasaki N, Omoto D, Nakamura M. Vedolizumab Attenuates Immune-Checkpoint-Therapy-Induced Infliximab-Refractory Colitis. Diagnostics (Basel) 2022; 12:diagnostics12020480. [PMID: 35204571 PMCID: PMC8870896 DOI: 10.3390/diagnostics12020480] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/06/2022] [Accepted: 02/10/2022] [Indexed: 02/01/2023] Open
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.
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Affiliation(s)
- Ayaka Kaneoka
- Correspondence: ak---; Tel.: +81-93-691-7445; Fax: +81-93-691-0907
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Randhawa M, Gaughran G, Archer C, Pavli P, Morey A, Ali S, Yip D. Vedolizumab in combined immune checkpoint therapy-induced infliximab-refractory colitis in a patient with metastatic melanoma: A case report. World J Clin Oncol 2019; 10:350-357. [PMID: 31799150 PMCID: PMC6885450 DOI: 10.5306/wjco.v10.i10.350] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/19/2019] [Accepted: 09/05/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Dual checkpoint inhibition improves response rates in treatment naïve patients with metastatic melanoma compared to monotherapy. However, it confers a higher rate of toxicity, including immune-related colitis. Steroids may not resolve symptoms in all cases. The use of vedolizumab, a humanized monoclonal antibody against α4β7 integrin has proven effective in cases refractory to standard treatment.
CASE SUMMARY We report the case of a 27-year-old female with Stage IVd metastatic melanoma treated with ipilimumab and nivolumab. She developed severe colitis refractory to methylprednisolone, infliximab and mycophenolate mofetil but responded to vedolizumab.
CONCLUSION This case report supports vedolizumab use in severe immune related colitis refractory to standard immunosuppression.
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Affiliation(s)
- Manreet Randhawa
- Department of Medical Oncology, Canberra Region Cancer Centre, The Canberra Hospital, Canberra, ACT 2605, Australia
| | - Gregory Gaughran
- Department of Medical Oncology, Canberra Region Cancer Centre, The Canberra Hospital, Canberra, ACT 2605, Australia
| | - Christine Archer
- Department of Medical Oncology, Canberra Region Cancer Centre, The Canberra Hospital, Canberra, ACT 2605, Australia
| | - Paul Pavli
- Department of Gastroenterology, The Canberra Hospital, Canberra, ACT 2605, Australia
- ANU Medical School, Australian National University, Canberra, ACT 2601, Australia
| | - Adrienne Morey
- Department of Anatomical Pathology, The Canberra Hospital, Canberra, ACT 2605, Australia
- ANU Medical School, Australian National University, Canberra, ACT 2601, Australia
| | - Sayed Ali
- Department of Medical Oncology, Canberra Region Cancer Centre, The Canberra Hospital, Canberra, ACT 2605, Australia
- ANU Medical School, Australian National University, Canberra, ACT 2601, Australia
| | - Desmond Yip
- Department of Medical Oncology, Canberra Region Cancer Centre, The Canberra Hospital, Canberra, ACT 2605, Australia
- ANU Medical School, Australian National University, Canberra, ACT 2601, Australia
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Randhawa M, Gaughran G, Archer C, Pavli P, Morey A, Ali S, Yip D. Vedolizumab in combined immune checkpoint therapy-induced infliximab-refractory colitis in a patient with metastatic melanoma: A case report. World J Clin Oncol 2019. [DOI: 10.5306/wjco.v10.i10.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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