A Case of Malignant Melanoma Associated with Polymyositis Treated with Immune Checkpoint Inhibitors

Immune checkpoint inhibitors have drastically changed in the treatment of many kinds of malignancies, especially malignant melanoma. The focus of the recent experiments has not only been on their efficacy but also immune-related adverse events (irAEs). We report a case of fulminant hepatitis due to nivolumab. In this case, the patient had undergone long-term nivolumab therapy. He did not complain of any symptoms but his liver enzyme levels were extremely elevated (grade 4). We promptly decided to start oral corticosteroids in the patient. His liver function rapidly improved. The dose of corticosteroids was gradually reduced. Our case demonstrates that sudden onset fulminant hepatitis can occur despite the safe use of long-term nivolumab therapy. The irAE can improve rapidly with proper corticosteroid treatment. This report will be useful for the physicians who always use immune checkpoint inhibitors.

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HBV-related acute hepatitis due to immune checkpoint inhibitors in a patient with malignant melanoma

Annals of Oncology ◽

10.1093/annonc/mdx502 ◽

2017 ◽

Vol 28 (12) ◽

pp. 3103-3104 ◽

Cited By ~ 21

Author(s):

A.S. Koksal ◽

B. Toka ◽

A.T. Eminler ◽

İ Hacibekiroglu ◽

M.I. Uslan ◽

...

Keyword(s):

Malignant Melanoma ◽

Acute Hepatitis ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors

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Multiple treatment comparison of seven new drugs for patients with advanced malignant melanoma: a systematic review and health economic decision model in a Norwegian setting

BMJ Open ◽

10.1136/bmjopen-2016-014880 ◽

2017 ◽

Vol 7 (8) ◽

pp. e014880 ◽

Cited By ~ 7

Author(s):

Eva Pike ◽

Vida Hamidi ◽

Ingvil Saeterdal ◽

Jan Odgaard-Jensen ◽

Marianne Klemp

Keyword(s):

Cost Effectiveness ◽

Malignant Melanoma ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Cost Effective ◽

Mek Inhibitor ◽

New Drugs ◽

Advanced Malignant Melanoma ◽

Quality Adjusted Life

ObjectiveTo assess the relative effectiveness and cost-effectiveness of seven new drugs (cobimetinib, dabrafenib, ipilimumab, nivolumab, pembrolizumab, trametinib and vemurafenib) used for treatment of patients with advanced malignant melanoma in the Norwegian setting.DesignA multiple technology assessment.PatientsPatients with advanced malignant melanoma aged 18 or older.Data sourcesA systematic search for randomised controlled trials in relevant bibliographic databases.MethodsWe performed network meta-analyses using both direct and indirect evidence with dacarbazine as a common comparator. We ranked the different treatments in terms of their likelihood of leading to the best results for each endpoint. The cost-utility analysis was based on a probabilistic discrete-time Markov cohort model. The model calculated the costs and quality-adjusted life years (QALYs) with different treatment strategies from a healthcare perspective. Sensitivity analysis was performed by means of Monte Carlo simulation.ResultsMonotherapies with a programmed cell death 1 (PD-1) immune-checkpoint-inhibitor had a higher probability of good performance for overall survival than monotherapies with ipilimumab or BRAF/MEK inhibitors. The combination treatments had all similar levels of effectiveness to the PD-1 immune-checkpoint-inhibitors.PD-1 immune-checkpoint-inhibitors are more effective and more costly compared with ipilimumab in monotherapy. Nivolumab in combination with ipilimumab had higher costs and the same level of effectiveness as the PD-1 immune-checkpoint-inhibitors in monotherapy.BRAF/MEK inhibitor combinations (dabrafenib and trametinib or vemurafenib and cobimetinib) had both similar effectiveness and cost-effectiveness; however, the combination therapies are more likely to give higher quality adjusted life year gains than BRAF or MEK inhibitor monotherapies, but to a higher cost.ConclusionsNone of the drugs investigated can be considered cost-effective at what has normally been considered a reasonable willingness-to-pay (WTP) in Norway. Price reductions (from the official list prices) in the region of 63%–84% would be necessary for these drugs to be cost-effective at a WTP of €55 850 per QALY.

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Successful Treatment of a Patient with anti-PD1 Antibody-Resistant Advanced Mucosal Melanoma with Nivolumab, Ipilimumab plus Denosumab Combination Therapy

Case Reports in Oncology ◽

10.1159/000506327 ◽

2020 ◽

Vol 13 (1) ◽

pp. 271-275 ◽

Cited By ~ 1

Author(s):

Taku Fujimura ◽

Yumi Kambayashi ◽

Kentaro Ohuchi ◽

Ryo Amagai ◽

Yota Sato ◽

...

Keyword(s):

Malignant Melanoma ◽

Combination Therapy ◽

Nasal Cavity ◽

Immune Checkpoint ◽

Cutaneous Melanoma ◽

Japanese Population ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Mucosal Melanoma ◽

Mutation Burden

Since the incidence of mucosal melanoma is higher in the Japanese population compared to Caucasians, and since mucosal melanoma possesses a lower mutation burden compared to cutaneous melanoma, the efficacy of anti-PD1 antibody (Ab) monotherapy for mucosal melanoma is limited. Therefore, other targeting molecules that enhance the anti-tumor effects of immune checkpoint inhibitors are needed. In this report, we present a case with anti-PD1 Ab-resistant recurrent malignant melanoma of the nasal cavity successfully treated with nivolumab, ipilimumab plus denosumab combination therapy.

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Malignant melanoma followed by the development of type I diabetes and thyroid dysfunction caused by immune checkpoint inhibitors : Two case reports

Skin Cancer ◽

10.5227/skincancer.33.22 ◽

2018 ◽

Vol 33 (1) ◽

pp. 22-29

Author(s):

Aya TAKAHASHI ◽

Masato AMAKATA ◽

Yoshiki SATO ◽

Megumi YOKOYAMA ◽

Kaduhisa HIRAHARA ◽

...

Keyword(s):

Malignant Melanoma ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Thyroid Dysfunction ◽

Checkpoint Inhibitors ◽

Type I Diabetes ◽

Case Reports ◽

Type I

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Use of immune checkpoint inhibitors prolonged overall survival in a Japanese population of advanced malignant melanoma patients: Retrospective single institutional study

The Journal of Dermatology ◽

10.1111/1346-8138.14637 ◽

2018 ◽

Vol 45 (11) ◽

pp. 1337-1339 ◽

Cited By ~ 8

Author(s):

Yoshiyuki Nakamura ◽

Yasuhiro Fujisawa ◽

Ryota Tanaka ◽

Hiroshi Maruyama ◽

Yosuke Ishitsuka ◽

...

Keyword(s):

Overall Survival ◽

Malignant Melanoma ◽

Immune Checkpoint ◽

Japanese Population ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Advanced Malignant Melanoma ◽

Melanoma Patients

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Bullous Pemphigoid Induced by Nivolumab in a Patient with Malignant Melanoma

Trends in Immunotherapy ◽

10.24294/ti.v4.i1.1210 ◽

2020 ◽

Vol 4 (1) ◽

pp. 7

Author(s):

Eriko Adachi ◽

Erina Yokoyama ◽

Yuna Yamagami ◽

Reiko Koga ◽

Yoshiaki Yoshikawa

Keyword(s):

Malignant Melanoma ◽

Bullous Pemphigoid ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Serum Levels ◽

Metastatic Malignant Melanoma ◽

Clear Correlation ◽

Cutaneous Toxicity ◽

The Status

Immune checkpoint inhibitors, such as nivolumab, have been recognized that the enhanced immune responses often lead to immune-related adverse events (irAEs) in various organs. Although cutaneous toxicity is one of the most common irAEs, bullous pemphigoid (BP) with immune checkpoint inhibitors is rare. Herein, the authors report a case of BP in a patient of the metastatic malignant melanoma of the brain under the treatment of nivolumab. It is notable that this case showed the clear correlation between the status of using of nivolumab and serum levels of anti-BP180 antibody. In addition, the skin eruptions in the case were mainly pruritic erosive or crusted papules and these clinical features may be the clinical characteristics of BP induced by nivolumab.

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Predictive and prognostic effect of ABO blood group on immune checkpoint inhibitors

Cancer Biomarkers ◽

10.3233/cbm-210455 ◽

2021 ◽

pp. 1-8

Author(s):

Yakup Ergun ◽

Selin Akturk Esen ◽

Murat Bardakci ◽

Gokhan Ucar ◽

Ziya Kalkan ◽

...

Keyword(s):

Malignant Melanoma ◽

Blood Group ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Blood Groups ◽

Abo Blood Group ◽

Blood Group System ◽

Advanced Malignant Melanoma ◽

The Relationship

BACKGROUND: The relationship of the ABO blood group system with the immune response is known, but its relationship with immune checkpoint inhibitors (ICIs) has not been clearly investigated until now. OBJECTIVE: In this study, the relationship between different blood groups and nivolumab treatment response in patients with advanced malignant melanoma was investigated. METHODS: The data of patients who used nivolumab for advanced malignant melanoma between April 2018 and April 2021 were retrospectively reviewed. RESULTS: A total of 73 patients were included in the study. In the progression-free survival (PFS) analysis according to blood groups, it was 3.9 months, 16.1 months, 20.0 months and 3.0 months for A, B, AB and O, respectively (p= 0.1). Overall survival (OS) analysis according to blood groups was 5.1 months, 25.0 months, 20.0 months and 9.3 months for A, B, AB and O, respectively (p= 0.1). The B antigen group (B or AB) had significantly longer PFS and OS than the non-B antigen group (A or O) (16.1 vs. 3.5 months for PFS, respectively, p= 0.03; 20.0 vs. 7.4 months for OS, respectively, p= 0.02). CONCLUSIONS: The presence of B antigen provides a significant advantage in terms of survival in patients using ICIs for advanced melanoma.

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