Case Report: A severe case of immunosuppressant-refractory immune checkpoint inhibitor-mediated colitis rescued by tofacitinib

Frontiers in Immunology

Immunology

Mark A. J. Gorris¹  Martijn J. H. Tjan²  Kalijn F. Bol²  Harm Westdorp³  Mark W. D. Sweep³ 

[1] Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, Netherlands;Division of Immunotherapy, Oncode Institute, Nijmegen, Netherlands;Department of Medical Oncology, Radboud University Medical Center, Nijmegen, Netherlands;Department of Medical Oncology, Radboud University Medical Center, Nijmegen, Netherlands;Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, Netherlands;

关键词: colitis;    immune checkpoint inhibitor;    tofacitinib;    adverse event;    cancer;    autoimmunity;    case report;   

DOI  :  10.3389/fimmu.2023.1212432

 received in 2023-04-26, accepted in 2023-06-12,  发布年份 2023

来源: Frontiers

【 摘 要 】

Immune checkpoint inhibitor therapy for cancer treatment can give rise to a variety of adverse events. Here we report a male patient with metastatic melanoma who experienced life-threatening colitis and duodenitis following treatment with ipilimumab and nivolumab. The patient did not respond to the first three lines of immunosuppressive therapy (corticosteroids, infliximab, and vedolizumab), but recovered well after administration of tofacitinib, a JAK inhibitor. Cellular and transcriptional data on colon and duodenum biopsies shows significant inflammation in the tissue, characterized by a large number of CD8 T cells and high expression of PD-L1. While cellular numbers do decrease during three lines of immunosuppressive therapy, CD8 T cells remain relatively high in the epithelium, along with PD-L1 expression in the involved tissue and expression of colitis-associated genes, indicating an ongoing colitis at that moment. Despite all immunosuppressive treatments, the patient has an ongoing tumor response with no evidence of disease. Tofacitinib might be a good candidate to consider more often for ipilimumab/nivolumab-induced colitis.

【 授权许可】

Unknown   
Copyright © 2023 Sweep, Tjan, Gorris, Bol and Westdorp