Vedolizumab in combined immune checkpoint therapy-induced infliximab-refractory colitis in a patient with metastatic melanoma: A case report.
Case report
Infliximab-refractory colitis
Ipilimumab
Metastatic melanoma
Nivolumab
Steroid-refractory colitis
Vedolizumab
Journal
World journal of clinical oncology
ISSN: 2218-4333
Titre abrégé: World J Clin Oncol
Pays: United States
ID NLM: 101549149
Informations de publication
Date de publication:
24 Oct 2019
24 Oct 2019
Historique:
received:
27
02
2019
revised:
22
07
2019
accepted:
05
09
2019
entrez:
5
12
2019
pubmed:
5
12
2019
medline:
5
12
2019
Statut:
ppublish
Résumé
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. 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. This case report supports vedolizumab use in severe immune related colitis refractory to standard immunosuppression.
Sections du résumé
BACKGROUND
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
METHODS
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
CONCLUSIONS
This case report supports vedolizumab use in severe immune related colitis refractory to standard immunosuppression.
Identifiants
pubmed: 31799150
doi: 10.5306/wjco.v10.i10.350
pmc: PMC6885450
doi:
Types de publication
Case Reports
Langues
eng
Pagination
350-357Informations de copyright
©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: The authors declare that they have no competing interests.
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