Vedolizumab in Combined Immune Checkpoint Therapy-induced Infliximab-refractory Colitis in a Patient with Metastatic Melanoma: A Case Report

Overview

Journal World J Clin Oncol

Publisher Baishideng Publishing Group

Specialty Oncology

Date 2019 Dec 5

PMID 31799150

Citations 5

Authors

Manreet Randhawa

Gregory Gaughran

Christine Archer

Paul Pavli

Adrienne Morey

Sayed Ali

Desmond Yip

Affiliations

Soon will be listed here.

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.

Citing Articles

A case of refractory immune checkpoint inhibitor-induced colitis improved by the treatment with vedolizumab and granulocyte-monocyte apheresis combination therapy.

Ishihara H, Watanabe T, Kumei S, Kume K, Yoshikawa I, Harada M Clin J Gastroenterol. 2023; 17(1):46-51.

PMID: 38041760 DOI: 10.1007/s12328-023-01887-7.

Pharmacological Treatments Available for Immune-Checkpoint-Inhibitor-Induced Colitis.

Ohwada S, Ishigami K, Akutsu N, Nakase H Biomedicines. 2022; 10(6).

PMID: 35740355 PMC: 9219666. DOI: 10.3390/biomedicines10061334.

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

Kaneoka A, Okada E, Sugino H, Saito-Sasaki N, Omoto D, Nakamura M Diagnostics (Basel). 2022; 12(2).

PMID: 35204571 PMC: 8870896. DOI: 10.3390/diagnostics12020480.

Immune Checkpoint Inhibitor-Induced Gastrointestinal Toxicity: The Opinion of a Gastroenterologist.

Macovei Oprescu A, Tulin R, Slavu I, Venter D, Oprescu C Cureus. 2022; 13(11):e19945.

PMID: 34976532 PMC: 8711857. DOI: 10.7759/cureus.19945.

Successful Treatment of an Immune-Mediated Colitis Induced by Checkpoint Inhibitor Therapy in a Patient with Advanced Melanoma.

Paparoupa M, Stupperich S, Goerg-Reifenberg L, Wittig A, Schuppert F Case Rep Gastroenterol. 2020; 14(3):554-560.

PMID: 33250697 PMC: 7670360. DOI: 10.1159/000511252.

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