Source/Disclosures
Disclosures: Powell reports serving as a speaker for Allergan, Falk, Janssen, Tillotts and Takeda, a consultant and/or an advisory board member for AbbVie, Allergan, Debiopharm International, Ferring and Vifor Pharma. He also reports receiving personal fees as a speaker for Allergan, Bristol-Myers Squibb, Falk, Janssen, Tillotts and Takeda, and as a consultant and/or an advisory board member for AbbVie, Allergan, Celgene, Ferring and Vifor Pharma.
September 15, 2020
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Entyvio, Remicade effective in checkpoint inhibitor-induced enterocolitis

Source/Disclosures
Disclosures: Powell reports serving as a speaker for Allergan, Falk, Janssen, Tillotts and Takeda, a consultant and/or an advisory board member for AbbVie, Allergan, Debiopharm International, Ferring and Vifor Pharma. He also reports receiving personal fees as a speaker for Allergan, Bristol-Myers Squibb, Falk, Janssen, Tillotts and Takeda, and as a consultant and/or an advisory board member for AbbVie, Allergan, Celgene, Ferring and Vifor Pharma.
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Remicade and Entyvio were effective for the treatment of patients with checkpoint inhibitor-induced enterocolitis, according to the results of a meta-analysis.

Nick Powell, of the division of digestive diseases at Imperial College London, and colleagues wrote the success of checkpoint inhibitors in cancer treatment comes with the downside of immune-mediate toxicity. Current therapy includes corticosteroids and Remicade (infliximab, Janssen).

“Checkpoint inhibitor-induced enterocolitis is one of the most serious immune-mediated complications and is especially common in combination regimens, affecting greater than 40%,” they wrote. “There are no randomized controlled studies evaluating the efficacy of anti-inflammatory therapy in this setting, with data mainly arising from small observational studies.”

Investigators searched the literature for studies that explored clinical outcomes of checkpoint inhibitor-induced enterocolitis in patients treated with anti-inflammatory agents. They studied variation in effect size with checkpoint inhibitor agent and tumor type as variables.

Across 39 studies comprising 1,210 patients, corticosteroids were effective in 59% of patients. Patients treated with anti-PD-1/L1 monotherapy had a more favorable response (78%) compared with those who received anti-CTLA-4 (56%; P = .04). Researchers also found that patients with lung cancer had a more favorable response than patients with melanoma (88% vs. 55%; P = .04).

Additionally, Powell and colleagues found that infliximab was effective in 81% of patients and Entyvio (vedolizumab, Takeda) was effective in 85% of patients.

“Responses to infliximab and vedolizumab were especially favorable, challenging current management paradigms,” they wrote. “These data emphasize the need for high-quality, prospective comparator studies to inform optimal management strategies for this emerging clinical problem.”