Cancer Treatment Today

Graft-versus-host disease (GVHD) represents a serious complication of allogeneic BMT and remains one of the most difficult challenges for clinicians. ENBREL is a type of protein called a tumor necrosis factor (TNF) blocker. Enbrel has had some effects in case reports but there has not been a prospective study. A 2012 guideline by Dignan et al considered this treatment but did not recommend due to lack of evidence. The article by Flowers in 2015 does not even list this option in Fig. 6.

However, recently there was a consensus conference on Pulmonary GVHD (Hildebrand et al) and it recommended Enbrel among other options.

G C Hildebrand, Diagnosis and treatment of pulmonary chronic GVHD: report from the consensus conference on clinical practice in chronic GVHD. Bone Marrow Transplantation (2011) 46, 1283–1295;

Bolanos-Meade J. Update on the management of acute graft-vs host disease, Curr Opin Oncol. 2006;18(2):120-125.

Yanik GA, et al, . Soluble tumor necrosis factor receptor: enbrel (etanercept) for subacute pulmonary dysfunction following allogeneic stem cell transplantation. Biol Blood Marrow Transplant 2012;18(7):1044-1054.

Kennedy GA, Butler J, Western R, et al. Combination antithymocyte globulin and soluble TNFalpha inhibitor (etanercept) +/- mycophenolate mofetil for treatment of steroid refractory acute graft-versus-host disease. Bone Marrow Transplant. 2006;37(12):1143-1147.
54.
Perez-Simon JA, Sanchez-Abarca I, Diez-Campelo M, et al. Chronic graft-versus-host disease: Pathogenesis and clinical management. Drugs. 2006;66(8):1041-1057.
A. Gulbis, Y. Hsu, J. Neumann, S. Hymes, M. de Lima, C. Hosing, I. Khouri, M. Qazilbash, P. Kebriaei, B. Andersson: Etanercept as salvage therapy for chronic graft-versus-host disease Biology of Blood and Marrow Transplantation, Volume 13, Issue 2, Pages 107-108, 2007

J.E. Levine et al, Etanercept plus methylprednisolone as initial therapy for acute graft-versus-host disease, Blood. Feb 15, 2008; 111(4): 2470–2475

M. Dignan FL, Amrolia P, Clark A, Cornish J, Jackson G, Mahendra P, Scarisbrick JJ, Taylor PC, Shaw BE, Potter MN, on behalf of the Haemato-oncology Task Force of the British Committee [trunc]. Diagnosis and management of chronic graft-versus-host disease. Br J Haematol. 2012 Jul;158(1):46-61. [125 references]

Mary E. D. Flowers and Paul J. Martin, How we treat chronic graft-versus-host diseaseJ. January 22, 2015; Blood: 125 (4)