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Expert Point of View: Brooks D. Cash, MD


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Brooks D. Cash, MD

Brooks D. Cash, MD

Brooks D. Cash, MD, Chief of Gastroenterology, Hepatology & Nutrition at McGovern Medical School at UTHealth in Houston, moderated the plenary session during the virtual edition of the American College of Gastroenterology 2020 Annual Scientific Meeting, where the data were presented. He believes the findings might trigger a change in how checkpoint inhibitor–mediated colitis is managed.

“Although this study is limited in its size and was a single-center, retrospective experience, the investigators present compelling data that have the potential to shift the therapy of checkpoint inhibitor–mediated colitis toward earlier use of vedolizumab in lieu of infliximab,” Dr. Cash offered.

“Obviously we’d like to see a prospective, adequately powered head-to-head trial, but these data represent the most complete comparison of these two agents for this increasingly important condition, and they may be enough to convince providers to move toward vedolizumab,” he explained. “It’s clear that checkpoint inhibitor–mediated colitis has relevance toward primary malignancy recurrence and overall mortality. Anything we can do to limit its negative effects on these outcomes without creating additional safety-related issues would be a welcome advance in the management of this condition.”

Dr. Cash continued: “The analysis by Dr. Wang and colleagues is very important. Gastroenterologists and oncologists alike should consider these data in their management of patients with checkpoint inhibitor–mediated colitis. Taking a cue from current events, I think it may be too early to declare a clear winner, but this research may very well serve as the foundation of a fundamental shift in the care of these patients toward improved outcomes for a number of important clinical endpoints.” 

DISCLOSURE: Dr. Cash reported no conflicts of interest.


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