How do you approach further treatment of patients who develop grade 2-3 immune colitis from nivolumab/ipilimumab prior to completion of the 4 ipilimumab doses?

Do you re-challenge with nivolumab alone, change from nivo 1/ipi 3 to nivo 3/ipi 1 upon re-challenge, or stop immunotherapy altogether if grade 3?

Answer from: Medical Oncologist at Community Practice

If the colitis completely resolves, I would consider a colonoscopy to be sure that subclinical microscopic lymphocytic colitis has completely resolved. If not, I would consider 3 dose of infliximab to reduce recurrence of colitis. Then once off steroids, I would restart single agent anti-PD1.

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How do you approach further treatment of patients who develop grade 2-3 immune colitis from nivolumab/ipilimumab prior to completion of the 4 ipilimumab doses?

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