Vedolizumab in combined immune checkpoint therapy-induced infliximab-refractory colitis in a patient with metastatic melanoma: A case report

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 huma...

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Autores principales: Randhawa, Manreet, Gaughran, Gregory, Archer, Christine, Pavli, Paul, Morey, Adrienne, Ali, Sayed, Yip, Desmond
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2019
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885450/
https://www.ncbi.nlm.nih.gov/pubmed/31799150
http://dx.doi.org/10.5306/wjco.v10.i10.350
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author Randhawa, Manreet
Gaughran, Gregory
Archer, Christine
Pavli, Paul
Morey, Adrienne
Ali, Sayed
Yip, Desmond
author_facet Randhawa, Manreet
Gaughran, Gregory
Archer, Christine
Pavli, Paul
Morey, Adrienne
Ali, Sayed
Yip, Desmond
author_sort Randhawa, Manreet
collection PubMed
description 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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spelling pubmed-68854502019-12-03 Vedolizumab in combined immune checkpoint therapy-induced infliximab-refractory colitis in a patient with metastatic melanoma: A case report Randhawa, Manreet Gaughran, Gregory Archer, Christine Pavli, Paul Morey, Adrienne Ali, Sayed Yip, Desmond World J Clin Oncol Case Report 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. Baishideng Publishing Group Inc 2019-10-24 2019-10-24 /pmc/articles/PMC6885450/ /pubmed/31799150 http://dx.doi.org/10.5306/wjco.v10.i10.350 Text en ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
Randhawa, Manreet
Gaughran, Gregory
Archer, Christine
Pavli, Paul
Morey, Adrienne
Ali, Sayed
Yip, Desmond
Vedolizumab in combined immune checkpoint therapy-induced infliximab-refractory colitis in a patient with metastatic melanoma: A case report
title Vedolizumab in combined immune checkpoint therapy-induced infliximab-refractory colitis in a patient with metastatic melanoma: A case report
title_full Vedolizumab in combined immune checkpoint therapy-induced infliximab-refractory colitis in a patient with metastatic melanoma: A case report
title_fullStr Vedolizumab in combined immune checkpoint therapy-induced infliximab-refractory colitis in a patient with metastatic melanoma: A case report
title_full_unstemmed Vedolizumab in combined immune checkpoint therapy-induced infliximab-refractory colitis in a patient with metastatic melanoma: A case report
title_short Vedolizumab in combined immune checkpoint therapy-induced infliximab-refractory colitis in a patient with metastatic melanoma: A case report
title_sort vedolizumab in combined immune checkpoint therapy-induced infliximab-refractory colitis in a patient with metastatic melanoma: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885450/
https://www.ncbi.nlm.nih.gov/pubmed/31799150
http://dx.doi.org/10.5306/wjco.v10.i10.350
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