This article is more than 5 years old. Information may no longer be current.
Cytotoxic chemotherapy helped to induce, maintain IBD remission
Patients with active IBD and extraintestinal malignancies were more likely to experience and maintain remission when receiving cytotoxic chemotherapy in a recent study.
Researchers evaluated data from 84 patients with Crohn’s disease (n=39) or ulcerative or indeterminate colitis (n=45) who had a solid, malignant extraintestinal neoplasm treated with cytotoxic chemotherapy, hormone therapy or a combination of the two. IBD remission rates following cancer treatment among 15 participants with active disease were recorded, along with the time to activation following treatment among 69 patients with inactive disease.
Ten of the active IBD patients experienced remission while receiving cancer treatment, with a median remission duration of 27 months. Five of these participants underwent cytotoxic chemotherapy, one received hormonal therapy and four received a combination of the two. Those who received cytotoxic chemotherapy were more likely to remain in remission after 5 years of follow-up compared with those who received hormone therapy alone or combination therapy (90% vs. 64%, P=.02).
Among patients with inactive IBD at cancer diagnosis, 12 developed active disease during treatment. Six of them received hormonal therapy, five received combination therapy and one received cytotoxic chemotherapy alone.
Investigators found patients to be at increased risk for activation when treated with cytotoxic chemotherapy and adjuvant hormonal therapy in combination (HR=9.71; 95% CI, 1.16-81.08), or with hormonal therapy alone (HR=11.04; 95% CI, 1.22-99.85) via multivariate analysis.
“The present study confirms an influential role of cancer treatment on the course of IBD,” the researchers concluded. “For patients with extraintestinal malignancy and active IBD, cytotoxic chemotherapy may provide a significant benefit in inducing and maintaining IBD remission... The present study may provide guidance for developing treatment plans and anticipating disease activity in patients undergoing cancer treatment, especially involving hormonal therapies. Additional studies are required to verify and further characterize the results.”