Summary
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.
Keywords
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Article info
Publication history
Published online: July 13, 2022
Accepted:
June 27,
2022
Received:
March 21,
2022
Footnotes
☆The data underlying this article will be shared on reasonable request to the corresponding author.
Identification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
