Atrash Shebli, Makhoul Issam, Mizell Jason S, Hutchins Laura, Mahmoud Fade
University of Arkansas for Medical Sciences, Little Rock, AR, USA.
J Oncol Pharm Pract. 2017 Apr;23(3):215-219. doi: 10.1177/1078155215627503. Epub 2016 Jul 8.
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.
使用检查点抑制剂的免疫疗法彻底改变了转移性黑色素瘤的治疗方式。伊匹单抗、纳武单抗和派姆单抗均为美国食品药品监督管理局（FDA）批准用于治疗转移性黑色素瘤的免疫检查点抑制剂。对免疫检查点抑制剂的反应通常会延迟。在治疗反应出现之前，重新分期的计算机断层扫描上可能会观察到“假性进展”这种中期进展情况。在此病例中，我们报告了转移性黏膜黑色素瘤在对免疫治疗产生有意义的反应之前出现了显著的中期进展。该患者出现了严重的免疫治疗相关结肠炎和新发白癜风。尽管停止了免疫治疗，但进一步重新分期的计算机断层扫描显示肿瘤持续有反应。
