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

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

Aurelien Amiot  1 , David Laharie  2 , Georgia Malamut  3 , Melanie Serrero  4 , Florian Poullenot  2 ; educational committee of the GETAID
Collaborators, Affiliations
Free article
Review

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

Aurelien Amiot et al. Dig Liver Dis. 2022 Sep.
Free article

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.

Keywords: Crohn's disease; Immune checkpoint inhibitor; Inflammatory bowel disease; Ulcerative colitis.

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Conflict of interest statement

Conflict of interest Aurelien Amiot has received consulting fees from Abbvie, Hospira, Takeda, Gilead and Biocodex as well as lecture fees and travel accommodations from Abbvie, Janssen, Biocodex, Hospira, Ferring, Takeda and MSD. This author has also received advisory board fees from Gilead, Takeda and Abbvie. David Laharie declares counselling, boards, transports, or personal fees from Abbvie, Biogaran, Biogen, Celgene, Celltrion, Ferring, Galapagos, HAC-pharma, Janssen, MSD, Novartis, Pfizer, Prometheus, Roche, Takeda, Theradiag, Tillots. Georgia Malamut declares consulting fees from Calypso, lecture fees from Janssen and Mayoli Spindler and congress registration fees from Janssen and Amgen Melanie Serrero has received lecture or consulting fees from Abbvie, Ferring, Amgen, Celltrion, Janssen, Ferring, Takeda and Tillotts. Florian Poullenot declares counselling, boards, transports, or personal fees from Abbvie, Biogen, Ferring, Janssen, MSD, Pfizer, Takeda. No conflicts of interest are claimed by the remaining authors.

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