Response of metastatic mucosal melanoma to immunotherapy: It can get worse before it gets better. (April 2017)

• Record Type: Journal Article
• Authors: Atrash, Shebli; Makhoul, Issam; Mizell, Jason S; Hutchins, Laura; Mahmoud, Fade
• Is Part Of: Journal of oncology pharmacy practice. Volume 23:Number 3(2017)
• Page Start: 215
• Page End: 219
• Publication Date: 2017-04
• Subjects: Ipilimumab -- mucosal melanoma -- pembrolizumab -- immunotherapy; Cancer -- Chemotherapy -- Periodicals; Clinical pharmacology -- Periodicals; 616.994061
• DOI: 10.1177/1078155215627503
• Languages: English
• ISSNs: 1078-1552

Abstract

Immune therapy with checkpoint inhibitors has revolutionized the management of metastatic melanoma. Ipilimumab, nivolumab, and pembrolizumab are all FDA-approved immune checkpoint inhibitors to treat metastatic melanoma. Responses to immune checkpoint inhibitors are usually delayed. An interim progression on restaging computed tomography scans "pseudo-progression" may be observed before response to treatment occur. In this case, we report a significant interim progression of metastatic mucosal melanoma before meaningful responses to immunotherapy occurred. The patient developed significant immune therapy-related colitis and new onset vitiligo. Further restaging computed tomography scans showed sustained tumor response despite stopping the immune therapy.