Tofacitinib and faecal microbiota transplantation in treating checkpoint inhibitor-induced enterocolitis: case report

BMJ Open Gastroenterol. 2022 Dec;9(1):e000989. doi: 10.1136/bmjgast-2022-000989.

Abstract

Background: Immune checkpoint inhibitors (ICIs) can induce a wide range of immune-related adverse events (irAEs), potentially affecting any organ. ICI-induced colitis is a frequently reported irAE, whereas enteritis is rare and not well documented.

Case presentation: We are presenting a patient with metastatic melanoma who developed severe ICI-induced enterocolitis multirefractory for glucocorticoids, infliximab and vedolizumab, partially responding to faecal microbiota transplantation and final complete response to tofacitinib.

Conclusion: This case supports that tofacitinib may be an(other) effective agent in managing multirefractory ICI-induced diarrhoea caused by colitis and/or enteritis.

Keywords: CANCER; IMMUNOTHERAPY; INFLAMMATORY BOWEL DISORDERS; INTESTINAL MICROBIOLOGY; MICROSCOPIC COLITIS.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents, Immunological* / adverse effects
  • Colitis* / drug therapy
  • Colitis* / therapy
  • Enterocolitis* / chemically induced
  • Enterocolitis* / therapy
  • Fecal Microbiota Transplantation / adverse effects
  • Humans

Substances

  • tofacitinib
  • Antineoplastic Agents, Immunological