title: Diarrhoea in a patient with metastatic melanoma: Ipilimumab ileocolitis treated with infliximab.
abstract: Administration of ipilimumab, a cytotoxic T-lymphocyte associated antigen-4-blocking monoclonal antibody, leads to enhancement of the anti-tumor T-cell respons and as a result shows a significant survival benefit in metastatic melanoma patients. Therefore patients are currently receiving this promising therapy as a second-line strategy. Unfortunately, by activation of the T-cell immune response, ipilimumab therapy may lead to an unwanted induction of different autoimmune phenomena. Diarrhoea and colitis occur in up to one third of patients. Here we present a case of ipilimumab induced ileocolitis which was successfully treated with infliximab, an anti-tumor necrosis factor monoclonal antibody, after corticosteroid therapy failure. Although formal trials are lacking, recently publicated series suggest that infusional therapy of infliximab is effective in ipilimumab induced ileocolitis.
authors.affiliation: Rob ME Slangen, Department of Gastroenterology and Hepatology, HagaZiekenhuis, 2545 CH Den Haag, The Netherlands.
authors.forename: Rob Me
authors.initials: RM
authors.lastname: Slangen
authors.forename: Alfonsus Jm
authors.initials: AJ
authors.lastname: van den Eertwegh
authors.forename: Adriaan A
authors.initials: AA
authors.lastname: van Bodegraven
authors.forename: Nanne Kh
authors.initials: NKh
authors.lastname: de Boer
keywords: Colitis; Cytotoxic T-lymphocyte associated antigen-4; Infliximab; Ipilimumab; Melanoma
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