Anti‐inflammatory therapy a win in checkpoint inhibitor‐induced enterocolitis

10 Oct 2020

Corticosteroids, infliximab, and vedolizumab are all beneficial in the treatment of patients with checkpoint inhibitor‐induced enterocolitis, according to a study.

Researchers conducted a systematic review and meta-analysis of studies evaluating the effectiveness of anti‐inflammatory therapy in checkpoint inhibitor‐induced enterocolitis. They searched multiple online databases and identified 39 studies eligible for inclusion.

The studies contributed to a total study population of 1,210 cancer patients who had developed immune checkpoint inhibitor‐induced enterocolitis and treated with anti‐inflammatory therapy. Cancer types included melanoma, lung cancer, urothelial cancer, prostate cancer, renal cell carcinoma, and Hodgkin's lymphoma, among others. Checkpoint inhibitors used were ipilimumab, tremelimumab, nivolumab, pembrolizumab, or anti‐PD‐L1. Corticosteroids and infliximab were the most frequently administered anti‐inflammatory agents.

Pooled data showed corticosteroids to be effective in 59 percent of the patients. The magnitude of effect varied by checkpoint inhibitor regimen and cancer type, such that corticosteroids produced a more favourable response among those treated with anti‐PD‐1/L1 monotherapy vs anti‐CTLA‐4 containing regimens (78 percent vs 56 percent; p=0.003) and among those with lung cancer vs melanoma (88 percent vs 55 percent; p=0.04).

Infliximab was effective in 81 percent of patients and vedolizumab, in 85 percent.

Associated with disabling symptoms and intestinal injury, checkpoint inhibitor‐induced enterocolitis is a common complication, which can lead to hospitalization and more serious conditions including intestinal perforation. The present data show that anti‐inflammatory agents have high success rates in the treatment of checkpoint inhibitor‐induced enterocolitis, the researchers said.

Editor's Recommendations