Can vedolizumab simplify the management of checkpoint inhibitor-induced enterocolitis?

Up-front vedolizumab therapy may offer a promising strategy to reduce corticosteroid use and facilitate the resumption of checkpoint inhibitors in patients with checkpoint inhibitor-induced enterocolitis.

Dr Emilie Kristine Dahl (Rigshospitalet, Denmark) and colleagues evaluated vedolizumab as up-front therapy for checkpoint inhibitor-induced enterocolitis to determine whether it could lower corticosteroid use and increase the number of patients able to restart checkpoint inhibitor treatment. The team enrolled 41 patients with solid tumours who had developed checkpoint inhibitor-induced enterocolitis and for whom corticosteroid therapy had been recommended. Participants were randomised 1:1 to receive vedolizumab or standard-of-care treatment, which consisted of corticosteroid tapering based on symptoms, with optional infliximab administration if needed. The primary endpoint was the cumulative corticosteroid dose within 30 weeks following diagnosis.

The mean cumulative corticosteroid dose was significantly lower in the vedolizumab arm than in the control arm after 10 weeks (1,157 mg vs 2,207 mg; P=0.036) but not after 30 weeks (1,378 mg vs 2,390 mg; P=0.107). Among participants who were corticosteroid-naïve at screening, corticosteroid use at 30 weeks was substantially lower in the vedolizumab arm than in the standard-of-care arm (314 mg vs 2,043 mg; 95% CI, 631-2,827). “33% of participants on vedolizumab were able to resume checkpoint inhibitors compared with 16.7% in the control arm,” noted Dr Dahl, “although the numbers were small.”

There were 25 serious adverse events (AEs) in the vedolizumab arm, most commonly diarrhoea (n=7). In the control arm, 21 serious AEs were observed, including 7 cases of diarrhoea and 8 infections.

“These findings suggest that vedolizumab treatment may enable earlier resumption of checkpoint inhibitors in affected patients,” concluded Dr Dahl. “However, larger studies are warranted to confirm these results.”

1. Dahl EK, et al. Up-front vedolizumab versus conventional treatment for checkpoint inhibitor induced colitis – VEICO: an open label randomised clinical trial. LB05, Late-breaking trials in IBD. UEG Week, 4-7 October 2025, Berlin, Germany.

Medical writing support was provided by Robert van den Heuvel.
Copyright ©2025 Medicom Publishing Group



Posted on 8 October 20258 October 2025