P201 - USE OF BIOLOGICS IN INFLAMMATORY BOWEL DISEASE PATIENTS ON CHEMOTHERAPY FOR CANCER
(Room Poster Hall)
19 Jan 18
5:30 PM
-
7:00 PM
Tracks:
Management of Complicated IBD
Background: Management of inflammatory bowel disease (IBD) remains a clinical challenge in patients with active cancer. Observational data have shown that treatment modification is made for either IBD and/or cancer once the diagnosis of cancer is made in such patients. Impact of these changes on the course of IBD and/or cancer and the use of biologics for IBD management with concomitant chemotherapy for cancer is not studied. Our aim is to assess the safety of concomitant biologic use with chemotherapy in IBD patients with cancer and assess IBD disease course with cancer treatment. Results: Three patients being followed at our IBD center for moderate-severe IBD controlled with biologics developed cancer. Patient demographics, current medications, cancer diagnosis, chemotherapy regimen, labs at the time of concomitant therapy and adverse events are shown in Table 1. All 3 patients have continued on biologics along with chemotherapy with no complications related to biologics. Also there was no modification of chemotherapy made due to excessive immunosuppression from biologics in all 3 patients. They remained in clinical remission during the course of cancer treatment. Conclusions: There is limited data evaluating the impact of biologics in clinical outcome of cancer patients. Due to paucity of data, guidelines still recommend against initiating anti-TNFs in patients with prior history of cancer. Use of anti-integrins may be more re-assuring due to gut specific nature of these medications. Discontinuing biologics during the course of cancer treatment may potentially lead to disease flare, immunocompromised state and non-responsiveness to drug upon resumption due to potential risk of antibody formation. In clinical practice, the decision to start or continue biologics in IBD patients with active cancer should be addressed with multi-disciplinary approach. Further studies need to be done to explore the safety of using biologics in cancer patients on chemotherapy.