A case of melanoma of the mandibular gingiva with long-term survival: Effect of nivolumab therapy and immuno-radiotherapy for cervical recurrence and nasal metastasis. Issue 5 (September 2022)

• Record Type: Journal Article
• Authors: Kitabatake, Takehiro; Kanno, Chihiro; Kaneko, Tetsuharu; Endo, Manabu; Yamazaki, Morio; Yaginuma, Sadanoshin; Akimoto, Tetsuo; Hasegawa, Hiroshi
• Is Part Of: Journal of oral and maxillofacial surgery, medicine, and pathology. Volume 34:Issue 5(2022)
• Page Start: 637
• Page End: 642
• Publication Date: 2022-09
• Subjects: Oral mucosal melanoma -- Anti-programmed cell death protein 1 antibody -- Immuno-radiotherapy; Mouth -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Oral medicine -- Periodicals; Mouth -- Diseases -- Pathogenesis -- Periodicals; Surgery, Oral -- Periodicals; Oral Medicine -- Periodicals; Pathology, Oral -- Periodicals; Face -- Surgery; Maxilla -- Surgery; Mouth -- Diseases -- Pathogenesis; Mouth -- Surgery; Oral medicine; Electronic journals -- Sciences; Electronic journals -- Medicine; Periodicals; 617.522059
• DOI: 10.1016/j.ajoms.2022.03.006
• Languages: English
• ISSNs: 2212-5566

Abstract

Abstract: Oral mucosal melanoma (OMM) is a rare disease with poor prognosis. Herein, we report a case of postoperative unresectable cervical recurrence of OMM that responded well to nivolumab monotherapy and showed a durable response after discontinuation of the drug; furthermore, a new metastatic lesion in the nasal cavity completely disappeared after immuno-radiotherapy with nivolumab. A 77-year-old patient with OMM of the left mandibular gingiva was treated with radical resection and postoperative adjuvant chemotherapy. After 3 months, skin metastasis was found on the left side of the neck, and tumorectomy and adjuvant radiation therapy were performed. However, 1 year later, an unresectable recurrent tumor was found in the deep neck space, following which nivolumab monotherapy (2 mg/kg every 3 weeks) was started. The lesion showed stable disease (SD) at 5 months after the first administration, and the monotherapy was continued for 3 years and 4 months. Thereafter, the treatment was discontinued for 18 months, during which time the lesion showed no progression, and no new lesions, including distant metastasis, were found. However, after discontinuation of the treatment, metastasis was found in the nasal cavity, and the patient underwent eight courses of nivolumab monotherapy (480 mg/body every 4 weeks) and concurrent radiotherapy (total dose, 40 Gy). Complete response (CR) was confirmed 6 months after the start of the treatment. The patient has survived for 8 years since the initial treatment, maintaining SD and CR of the cervical and nasal lesions, respectively.