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

Immune Checkpoint Inhibitors; Colitis; Diarrhea; Humans; Inflammatory Bowel Diseases; Neoplasms; Recurrence; Retrospective Studies; Crohn's disease; Immune checkpoint inhibitor; Inflammatory bowel disease; Ulcerative colitis

Abstract :

[en] 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.

Disciplines :

Gastroenterology & hepatology

Author, co-author :

Amiot, Aurelien; Department 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.

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

Malamut, Georgia; Department of Gastroenterology, AP-HP-Centre, Université de Paris, Hôpital Cochin, Paris, France.

Serrero, Melanie; Department of Gastroenterology, University Hospital of Marseille Nord, Aix-Marseille, Marseille University, Marseille, France.

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

educational committee of the, G E T A I D

Other collaborator :

Peyrin-Biroulet, Laurent

Laharie, David

Bourreille, Arnaud

Vuitton, Lucine

Bouguen, Guillaume

Abitbol, Vered

Amiot, Aurelien

Biron, Amelie

Bourrier, Anne

Caillo, Ludovic

More authors (24 more)

Language :

English

Title :

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

Publication date :

September 2022

Journal title :

Digestive and Liver Disease

eISSN :

1878-3562

Volume :

Issue :

Pages :

1162-1167

Data Set :

10.1016/j.dld.2022.06.020

Commentary :

Available on ORBi :

since 25 January 2024

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