Autoimmune colitis and neutropenia in adjuvant anti-PD-1 therapy for malignant melanoma: efficacy of Vedolizumab, a case report. (January 2022)

• Record Type: Journal Article
• Authors: d'Apolito, Maria; Spagnuolo, Rocco; Siciliano, Maria Anna; Barbieri, Vito; Cosco, Cristina; Fiorillo, Lucia; Cuomo, Onofrio; Zuccalà, Valeria; Correale, Pierpaolo; Pensabene, Licia; Rossi, Marco; Doldo, Patrizia; Tassone, Pierfrancesco; Tagliaferri, Pierosandro
• Is Part Of: Therapeutic advances in chronic disease. Volume 13(2022)
• Publication Date: 2022-01
• Subjects: anti-PD-1 -- melanoma -- autoimmunity -- colitis -- neutropenia -- immune-relate adverse events -- irAEs -- Pembrolizumab -- Vedolizumab; Chronic diseases -- Periodicals; Chronic diseases -- Treatment -- Periodicals; Chronic Disease -- Periodicals; Chronic Disease -- therapy -- Periodicals; 616.044
• DOI: 10.1177/20406223211063024
• Languages: English
• ISSNs: 2040-6223

Abstract

Immune checkpoint inhibitors (ICIs) represent an important advance in the adjuvant treatment of patients with high-risk melanoma. Although the safety profile of anti-programmed cell death protein-1 (PD-1) is fairly acceptable, different immune-related adverse events (irAEs) are described. Herein we report for the first time a notably multidisciplinary combined approach on a malignant melanoma (MM) patient treated with anti-PD-1 antibody in adjuvant setting. In this novel approach, corticosteroid-refractory immune-mediated colitis (IMC) was effectively treated with Vedolizumab, a selective blockade of the α4β7 integrin and corticosteroids were successfully administered for autoimmune neutropenia. Notably, our patient also express HLA-B*35, a potential biomarker for predicting a genetic basis of autoimmune susceptibility. Our experience offers a possible future perspective about the use of Vedolizumab together with immunotherapy in a strategic early approach for high-risk patients genotyped for HLA.