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

Aurelien Amiot ¹, David Laharie ², Georgia Malamut ³, Melanie Serrero ⁴, Florian Poullenot ², educational committee of the GETAID

Collaborators

educational committee of the GETAID: 

Laurent Peyrin-Biroulet, David Laharie, Arnaud Bourreille, Lucine Vuitton, Guillaume Bouguen, Vered Abitbol, Aurelien Amiot, Amelie Biron, Anne Bourrier, Ludovic Caillo, Mathurin Fumery, Cyrielle Gilletta, Laurianne Plastaras, Melanie Serrero, Marion Simon, Stephanie Viennot, Philippe Seksik, Alain Attar, Anthony Buisson, Benedicte Caron, Maeva Charkaoui, Jean-Marc Gornet, Lucas Guillo, Catherine Le Berre, Edouard Louis, Georgia Malamut, Nicolas Mathieu, Maria Nachury, Stephane Nancey, Stephane Paul, Catherine Reenaers, Xavier Treton, Mathieu Uzzan, Pauline Wils

Author information

¹Department 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.

²CHU de Bordeaux, Hôpital Haut-Lévêque, Service d'Hépato-gastroentérologie et oncologie digestive - Université de Bordeaux, F-33000 Bordeaux, France.

³Department of Gastroenterology, AP-HP-Centre, Université de Paris, Hôpital Cochin, Paris, France.

⁴Department of Gastroenterology, University Hospital of Marseille Nord, Aix-Marseille, Marseille University, Marseille, France.

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.