title: Vedolizumab: a novel treatment for ipilimumab-induced colitis.
abstract: Use of the immune checkpoint inhibitors, ipilimumab and nivolumab, has revolutionised treatment in patients with metastatic melanoma. However, these drugs can cause an autoimmune enterocolitis, with diarrhoea as the presenting symptom. This is conventionally managed by prompt institution of corticosteroid therapy if moderate diarrhoea (3-6 times/day; grade 2) is present for >5 days or if diarrhoea is severe (>6 times/day; grade 3). We report a case of steroid-dependent ipilimumab-induced colitis successfully treated with vedolizumab (an inhibitor of memory T-cell trafficking to the gut), after which complete withdrawal of corticosteroid was achieved. Hence, vedolizumab warrants further evaluation as a potential novel treatment of ipilimumab-induced colitis.
authors.affiliation: Department of Medical Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Amy Hsin-Chieh
authors.initials: AH
authors.lastname: Hsieh
authors.affiliation: Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Mutaz
authors.initials: M
authors.lastname: Ferman
authors.affiliation: Department of Medical Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Brown
authors.affiliation: Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Andrews
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D003092:Colitis / Q000139:chemically induced* / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000074324:Ipilimumab; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D005765:Gastrointestinal Agents; D000074324:Ipilimumab; C543529:vedolizumab