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

Manreet Randhawa; G Gaughran; Christine Archer; Paul Pavli; Adrienne Morey; Sayed Ali; Desmond Yip

doi:10.5306/wjco.v10.i10.350

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

Manreet Randhawa, G Gaughran, Christine Archer, Paul Pavli, Adrienne Morey, Sayed Ali, Desmond Yip

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND Dual checkpoint inhibition improves response rates in treatment naï¿½ve 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 Î±4Î²7 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.

Original language	English
Pages (from-to)	350-357
Journal	World Journal of Clinical Oncology
Volume	10
Issue number	10
DOIs	https://doi.org/10.5306/wjco.v10.i10.350
Publication status	Published - 2019

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

abstract = "BACKGROUND Dual checkpoint inhibition improves response rates in treatment na{\"i}¿½ve 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 {\^I}±4{\^I}²7 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.",

author = "Manreet Randhawa and G Gaughran and Christine Archer and Paul Pavli and Adrienne Morey and Sayed Ali and Desmond Yip",

year = "2019",

doi = "10.5306/wjco.v10.i10.350",

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T1 - Vedolizumab in combined immune checkpoint therapy-induced infliximab-refractory colitis in a patient with metastatic melanoma: A case report

AU - Randhawa, Manreet

AU - Gaughran, G

AU - Archer, Christine

AU - Pavli, Paul

AU - Morey, Adrienne

AU - Ali, Sayed

AU - Yip, Desmond

PY - 2019

Y1 - 2019

N2 - BACKGROUND Dual checkpoint inhibition improves response rates in treatment naï¿½ve 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 Î±4Î²7 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.

AB - BACKGROUND Dual checkpoint inhibition improves response rates in treatment naï¿½ve 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 Î±4Î²7 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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DO - 10.5306/wjco.v10.i10.350

M3 - Article

VL - 10

SP - 350

EP - 357

JO - World Journal of Clinical Oncology

JF - World Journal of Clinical Oncology

IS - 10

ER -

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

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