Description of the goods or services required
The Health Technology Assessment Programme is accepting stage 1 applications to their commissioned workstream for this primary research topic:
19/31 Gastrointestinal side effects in cancer immune checkpoint therapy
The immune checkpoint inhibitor drugs (ipilimumab, nivolumab and pembrolizumab) are indicated
(and recommended) for a number of malignancies including advanced melanoma, non-small-cell
lung cancer and advanced renal cell carcinoma.
While these drugs can provide significant survival advantage over existing treatments they can and
do cause a range of immune related adverse effects including diarrhoea and colitis which can be
potentially fatal. How best to manage these treatment related adverse events is uncertain with
current guidance generally based on clinical experience of the use of these agents in clinical
studies, and accounting for what is known of their potential mechanisms of toxicity.
Treatment with steroids is the mainstay of management but the use of infliximab, another expensive
toxic monoclonal antibody, is also indicated. The optimum strategy for use of these, and other,
agents is however unclear and prospective trials are required to provide evidence to aid decision
making for clinicians and patients which balances quality of life, effectiveness of the primary
treatment as well as resource use.