Reducing Recurrence of Immune-Mediated Colitis for Cancer Patients

Vedolizumab treatment was associated with lower IMC recurrence rate after ICI resumption.

Selective immunosuppressive therapy (SIT) with immune checkpoint inhibitors (ICI) results in significantly reduced immune-mediated colitis (IMC) recurrence in cancer patients.

In data presented during the 2021 Digestive Disease Week (DDW) Virtual Meeting, a team of researchers led by Yinghong Wang, MD, PhD, The University of Texas MD Anderson Cancer Center, examined the recurrence rate of immune-mediated colitis after resuming ICI on maintenance IMC therapy.

In the 102 patient study, the investigators examined patients rechallenged with ICI therapy following adequate treatment of first IMC with corticosteroids and either infliximab or vedolizumab. Of the 102 patients, 48 received SIT maintenance in conjunction with ICI resumption, while 54 patients did not.

Individuals on concurrent SIT were more likely to have received combined ICI regimen (60% vs 41%; P = 0.003), longer initial ICI treatment (108 vs 56 days; P = 0.014) with more initial ICI doses (9 vs 5 doses; P = 0.030) compared to the group with no concurrent SIT.

The concurrent SIT group received ICI treatment for significantly longer duration after resumption (72 vs 62 days; P = 0.023), resumed more ICI doses (5 vs 4 doses, P = 0.038), and had lower IMC recurrence (17% vs 37%; P = 0.027), while higher numbers of SIT doses (OR, 0.72; 95% CI, 0.55-0.94; P = 0.012), SIT maintenance treatment (OR, 0.34; 95% CI, 0.13-0.87; P = 0.024), and vedolizumab treatment (OR, 0.23; 95% CI, 0.07-0.74; P = 0.014) were associated with lower IMC recurrence rate after ICI resumption.

In an interview with HCPLive®, Wang discussed the results and how the study may shape treatment plans moving forward.