Sponghini Andrea, Patrucco Federica, Giorgione Roberto, Farinelli Pamela, Zottarelli Francesca, Rondonotti David, Savoia Paola
aDepartment of Oncology, Maggiore Hospital bDepartment of Health Sciences, University of Eastern Piedmont, Novara, Italy.
Anticancer Drugs. 2017 Aug;28(7):808-810. doi: 10.1097/CAD.0000000000000515.
The advent of immune checkpoint inhibitors anti-PD-1/PD-L1 has delivered new and effective treatment options with proven clinical benefits for patients affected by metastatic melanoma. The 30-40% of treated patients experience an objective tumour regression, with a significantly prolonged survival and an improved quality of life. Here, we report a case of a 75-year-old Caucasian woman affected by a massive cutaneous metastasis from a BRAF wild-type melanoma who experienced multiple relapses after surgery and repeated electrochemotherapy treatments. A poor response was observed after systemic therapy with ipilimumab, whereas a marked reduction in the lesion size was obtained during the treatment with nivolumab, with an objectively complete response after 6 months. Therapy was well tolerated, without immune-related side effects. During treatment, LDH levels decreased up to the standard values. Our experience confirms the good efficacy and the safety of anti-PD-1 nivolumab for the treatment of relapsed or refractory massive skin lesions, also in elderly patients.
免疫检查点抑制剂抗程序性死亡蛋白-1（PD-1）/程序性死亡配体-1（PD-L1）的出现为转移性黑色素瘤患者带来了新的有效治疗选择，且已证实具有临床益处。30%至40%接受治疗的患者出现客观肿瘤退缩，生存期显著延长，生活质量得到改善。在此，我们报告一例75岁白种女性患者，患有BRAF野生型黑色素瘤的巨大皮肤转移灶，术后及反复接受电化学疗法治疗后多次复发。使用伊匹单抗进行全身治疗后反应不佳，而使用纳武单抗治疗期间病灶大小显著缩小，6个月后达到客观完全缓解。治疗耐受性良好，无免疫相关副作用。治疗期间，乳酸脱氢酶（LDH）水平降至标准值。我们的经验证实了抗PD-1纳武单抗治疗复发或难治性巨大皮肤病变的良好疗效和安全性，老年患者亦是如此。
