Successful 15-step desensitization protocol for nivolumab and ipilimumab after a skin-test confirmed anaphylaxis to polysorbate 80: case report.

IF 1.8 4区医学 Q3 DERMATOLOGY

Melanoma Research Pub Date : 2026-08-24 DOI:10.1097/CMR.0000000000001133

Clement Svabek, Sophie Maiezza, Arthur Lecoutre, Justin Courtin, Marie Boileau, Delphine Staumont-Sallé, Laurent Mortier, Frederic Dezoteux

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引用次数: 0

Abstract

Checkpoint inhibitors (CPIs) are essential in advanced melanoma but may cause rare, potentially life-threatening hypersensitivity reactions. We report a 53-year-old man who developed grade III anaphylaxis during his first nivolumab infusion. Allergy testing identified immediate hypersensitivity to polysorbate 80 (PS80), an excipient shared by several CPIs, while testing for polysorbate 20 was also positive, limiting alternative treatment options. Following melanoma progression requiring combined immunotherapy, a one-bag, 15-step desensitization protocol was developed for sequential administration of nivolumab and ipilimumab. Both desensitizations were successfully completed without anaphylaxis, allowing subsequent administration of standard doses. This case demonstrates the feasibility of desensitization to both nivolumab and ipilimumab in a patient with confirmed PS80 hypersensitivity and provides a practical therapeutic option when no suitable excipient-free CPI is available.

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nivolumab和ipilimumab在皮肤试验确认对聚山梨酯过敏80后成功的15步脱敏方案：病例报告。

检查点抑制剂（CPIs）在晚期黑色素瘤中是必不可少的，但可能导致罕见的、潜在危及生命的超敏反应。我们报告了一位53岁的男性，他在第一次纳武单抗输注期间发生了III级过敏反应。过敏测试发现对聚山梨酯80 （PS80）立即过敏，这是几种cpi共用的赋形剂，而对聚山梨酯20的测试也呈阳性，限制了替代治疗方案。在黑色素瘤进展需要联合免疫治疗后，开发了一种单袋15步脱敏方案，用于顺序给药纳武单抗和伊匹单抗。两次脱敏均成功完成，无过敏反应，允许随后给予标准剂量。该病例证明了在PS80超敏患者中对nivolumab和ipilimumab脱敏的可行性，并在没有合适的无辅料CPI时提供了一种实用的治疗选择。

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来源期刊

Melanoma Research 医学-皮肤病学

CiteScore

3.40

自引率

4.50%

发文量

139

审稿时长

6-12 weeks

期刊介绍： Melanoma Research is a well established international forum for the dissemination of new findings relating to melanoma. The aim of the Journal is to promote the level of informational exchange between those engaged in the field. Melanoma Research aims to encourage an informed and balanced view of experimental and clinical research and extend and stimulate communication and exchange of knowledge between investigators with differing areas of expertise. This will foster the development of translational research. The reporting of new clinical results and the effect and toxicity of new therapeutic agents and immunotherapy will be given emphasis by rapid publication of Short Communications. Thus, Melanoma Research seeks to present a coherent and up-to-date account of all aspects of investigations pertinent to melanoma. Consequently the scope of the Journal is broad, embracing the entire range of studies from fundamental and applied research in such subject areas as genetics, molecular biology, biochemistry, cell biology, photobiology, pathology, immunology, and advances in clinical oncology influencing the prevention, diagnosis and treatment of melanoma.