Regression of a melanoma brain metastasis that had appeared after immune checkpoint inhibitor discontinuation: a hypothesis-generating case.

IF 1.6 4区 医学 Q2 Medicine
Acta Clinica Belgica Pub Date : 2023-12-01 Epub Date: 2023-07-19 DOI:10.1080/17843286.2023.2238374
Julien Pierrard, Emmanuel Seront, Rachel Galot, Idil Gunes Tatar, Jean-François Baurain, Dario Di Perri
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引用次数: 0

Abstract

We present the case of a 50-year-old woman previously treated with nivolumab-ipilimumab combination therapy for a metastatic melanoma. Despite premature discontinuation of these immune checkpoint inhibitors (ICIs) after 2 cycles due to severe immune-related hepatitis, the patient achieved a complete response. Nine months later, brain magnetic resonance imaging (MRI) showed progression of a single cerebral lesion, and the patient was referred for stereotactic radiosurgery. Unexpectedly, the brain MRI acquired one month later as part of radiosurgery planning showed a spontaneous regression of this lesion, allowing for radiosurgery cancellation. Follow-up imaging showed a sustained response, although the patient did not receive any other oncological treatment. We discuss here the potential immune mechanisms involved in this unusual course and the importance of better understanding the behaviour of tumours in the era of ICIs.

免疫检查点抑制剂停用后出现的黑色素瘤脑转移的消退:一个产生假设的病例。
我们介绍了一例50岁的妇女,她曾接受尼沃单抗-易普利姆单抗联合治疗转移性黑色素瘤。尽管由于严重的免疫相关肝炎,这些免疫检查点抑制剂(ICIs)在2个周期后提前停用,但患者获得了完全的反应。九个月后,大脑磁共振成像(MRI)显示单个大脑病变的进展,患者被转诊接受立体定向放射外科治疗。出乎意料的是,一个月后作为放射外科计划的一部分获得的大脑MRI显示,该病变自发消退,可以取消放射外科手术。尽管患者没有接受任何其他肿瘤学治疗,但随访成像显示持续的反应。我们在这里讨论了这一不寻常过程中涉及的潜在免疫机制,以及更好地了解ICIs时代肿瘤行为的重要性。
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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica 医学-医学:内科
CiteScore
2.90
自引率
0.00%
发文量
44
审稿时长
6-12 weeks
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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