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Immunomodulators for Steroid-Dependent Recurrent Acute Pancreatitis After Immune Checkpoint Inhibitor Therapy: A Case
Hannah Peck1, Wilfredo Pagani2, Arianna Smith3
1Medical College of Wisconsin, Milwaukee, WI.
ACG Case Reports Journal
|April 4, 2025
Summary
Immune checkpoint inhibitor-induced pancreatitis (ICI-IP) can recur. Immunomodulators like mycophenolate mofetil and azathioprine effectively managed recurrent ICI-IP in two patients, preventing further episodes.
Area of Science:
- Immunology
- Gastroenterology
- Oncology
Background:
- Immune checkpoint inhibitors (ICIs) are crucial cancer therapies.
- 1-2% of patients on ICIs develop ICI-induced pancreatitis (ICI-IP).
- Recurrent ICI-IP can occur even after ICI cessation.
Observation:
- This case series details two patients with recurrent ICI-IP.
- Both patients experienced steroid-responsive pancreatitis.
- They were treated with immunomodulators as steroid-sparing agents.
Findings:
- Immunomodulators, specifically mycophenolate mofetil and azathioprine, were used for management.
- Patients were maintained on these agents for approximately two years.
- No recurrence or complications of pancreatitis were observed after treatment.
Implications:
- Immunomodulators offer a viable steroid-sparing strategy for recurrent ICI-IP.
- This approach may improve long-term outcomes for patients with ICI-IP.
- Further research into immunomodulatory treatments for ICI-IP is warranted.
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