Abstract

Management of immune checkpoint inhibitor in patients with cancer and pre-existing inflammatory bowel disease: Recommendations from the GETAID

Dig Liver Dis2022 Sep;54(9):1162-1167. doi: 10.1016/j.dld.2022.06.020.Epub 2022 Jul 13.

 

Aurelien Amiot 1David Laharie 2Georgia Malamut 3Melanie Serrero 4Florian Poullenot 2educational committee of the GETAID

 

Collaborators

educational committee of the GETAID: 

Laurent Peyrin-BirouletDavid LaharieArnaud BourreilleLucine VuittonGuillaume BouguenVered AbitbolAurelien AmiotAmelie BironAnne BourrierLudovic CailloMathurin FumeryCyrielle GillettaLaurianne PlastarasMelanie SerreroMarion SimonStephanie ViennotPhilippe SeksikAlain AttarAnthony BuissonBenedicte CaronMaeva CharkaouiJean-Marc GornetLucas GuilloCatherine Le BerreEdouard LouisGeorgia MalamutNicolas MathieuMaria NachuryStephane NanceyStephane PaulCatherine ReenaersXavier TretonMathieu UzzanPauline Wils

 
     

Author information

1Department of Gastroenterology, Hopitaux Universitaires Bicêtre, AP-HP, Universite Paris Est Creteil, Le Kremlin Bicêtre, France; INSERM, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France. Electronic address: aurelien.amiot@aphp.fr.

2CHU de Bordeaux, Hôpital Haut-Lévêque, Service d'Hépato-gastroentérologie et oncologie digestive - Université de Bordeaux, F-33000 Bordeaux, France.

3Department of Gastroenterology, AP-HP-Centre, Université de Paris, Hôpital Cochin, Paris, France.

4Department of Gastroenterology, University Hospital of Marseille Nord, Aix-Marseille, Marseille University, Marseille, France.

Abstract

Background and aims: There is no consensus on the management of immune checkpoint inhibitor (ICI) for treating cancer in patients with pre-existing inflammatory bowel disease (IBD). The Groupe d'Étude Thérapeutique des Affections Inflammatoires du tube Digestif (GETAID) aimed to provide recommendations on this topic.

Methods: A dedicated working group performed a comprehensive expert-based review of the literature, generated clinical key question and shaped recommendations that were further voted for approval by the educational and scientific committees of the GETAID. Using consensus methods, treatment modalities were defined by vote.

Results: Majority of patients with IBD in clinical remission can be treated with ICI after cancer diagnosis. The rate of relapse or immune-related diarrhoea or colitis upon ICI treatment is up to 39.8% and is maximal with ICI combination therapy compared to monotherapies. When starting ICI in a patient with IBD, it is recommended to assess disease activity and pursue ongoing maintenance therapy. In case of relapse or immune-related diarrhoea or colitis upon ICI treatment, treatment depends on grading of diarrhoea or colitis and may include corticosteroid therapy, infliximab and/or vedolizumab.

Conclusions: In the present publication, we provided recommendations, which may assist gastroenterologists, haematologists, and oncologists for a better management of patients with pre-existing IBD before and during cancer treatment with ICI.

© Copyright 2013-2022 GI Health Foundation. All rights reserved.
This site is maintained as an educational resource for US healthcare providers only. Use of this website is governed by the GIHF terms of use and privacy statement.