Department of Medical Oncology, St Bartholomew's Hospital, London, UK.
Department of Ocular Oncology, Moorfields Eye Hospital, London, UK.
Pigment Cell Melanoma Res. 2017 Jan;30(6):558-562. doi: 10.1111/pcmr.12607. Epub 2017 Jul 23.
The use of immune checkpoint inhibition has led to major improvements in outcome for patients with metastatic cutaneous melanoma. The combination of ipilimumab and nivolumab has demonstrated greater activity over single-agent immunotherapy in phase III trials. Clinical trials of combination CTLA-4 and PD-1 inhibition are underway in uveal melanoma, for which there are currently no data. Here, we present the case of a 74-year-old male patient with metastatic uveal melanoma, who was treated with a combination of ipilimumab and nivolumab. He developed sequential autoimmune transaminitis, diabetes and uveitis, which necessitated discontinuation of maintenance nivolumab 3 months after commencement of treatment. The patient continues to demonstrate an ongoing partial response 10 months from the initial combination immunotherapy, with the evidence of depigmentation of the primary ocular tumour.
免疫检查点抑制的应用导致转移性皮肤黑色素瘤患者的预后有了重大改善。在三期临床试验中，ipilimumab 和 nivolumab 的联合应用比单药免疫治疗显示出更高的活性。目前，尚无数据显示 CTLA-4 和 PD-1 抑制联合应用于葡萄膜黑色素瘤的临床试验。在此，我们报告了一例转移性葡萄膜黑色素瘤 74 岁男性患者的病例，他接受了 ipilimumab 和 nivolumab 的联合治疗。他先后发生自身免疫性转氨基酶升高、糖尿病和葡萄膜炎，这使得他在开始治疗 3 个月后不得不停止维持性 nivolumab 治疗。从初始联合免疫治疗开始 10 个月后，患者仍持续显示部分缓解，原发眼部肿瘤的色素减退也有证据。
