87P - Access to vedolizumab for the management of immune-related colitis (IRC): A United Kingdom study

Background

Systemic anticancer therapies have advanced beyond cytotoxic agents; checkpoint inhibitors have revolutionised cancer therapeutics and are now in routine use across multiple disease sites. The mechanism of action places patients at risk of immune-related (IR) side effects including IR colitis (IRC). The management of IRC is described in guidelines, however, in the UK access to some recommended therapies, particularly for steroid refractory IRC, including vedolizumab, remains unclear. We aimed to evaluate vedolizumab access and usage for IRC in UK hospitals.

Methods

We surveyed the use of vedolizumab across UK hospitals; the questionnaire was available between June and July 2024. Questions were developed to identify current practice focusing on preferred treatment guidelines, access to vedolizumab and treatment pathways. An electronic Microsoft Forms questionnaire was disseminated across 2 platforms; via email to all British Oncology Pharmacy Association (BOPA) members, and via presentation and QR code to Immuno-Oncology Clinical Network (IOCN) members for real-time completion. After removing duplicate hospital entries, data was analysed and grouped into themes.

Results

A total of 74 responses were received: 46% by pharmacists (n=34) and 31% by doctors (n=23). Duplicate hospital sites were subsequently combined, and the remaining 46 responses analysed. 65% hospitals (n=30) use ESMO or Clatterbridge cancer centre IRC guidelines. 93% hospitals (n=43) use infliximab 1st line in steroid refractory IRC. 57% hospitals (n=26) have used vedolizumab for 2nd line use, whilst 11% (n=5) hospitals have used it at any line of their IRC treatment pathway. 22% (n=10) hospitals have never used vedolizumab of which funding, experience, willingness to prescribe and lack of place in existing treatment pathways; are contributing factors.

Conclusions

Vedolizumab is used as a 2nd line option for IRC in over half of responding hospitals, however, there is disparity in its usage. The barriers to implementation appear to be primarily driven by funding, willingness to prescribe and experience. Real-world studies on the efficacy of Vedolizumab are warranted to further establish its place in the IRC pathway to recommend as a treatment option.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.