Hillman Cancer Center, UPMC, Pittsburgh, PA, United States.
Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
Front Immunol. 2021 Mar 22;12:660795. doi: 10.3389/fimmu.2021.660795. eCollection 2021.
Immune-checkpoint inhibition has improved outcomes in metastatic melanoma. However, limited data describes the safety and efficacy of this treatment in the setting of cardiac allograft. Emerging translational and clinical evidence suggests that the majority of the benefit from these therapies is driven by the initial dose(s), and that attenuated dosing schedules may be as effective as continuous treatment.
We present a case vignette of a cardiac transplant recipient with metastatic melanoma who experienced six months of clinical benefit after one dose of pembrolizumab and did not suffer allograft rejection.
This case adds to the current available literature on the administration of checkpoint inhibitors in patients with cardiac allografts. Further, it explores potential markers of immunotherapy response and supports the potential of shorter or individualized immune-checkpoint blockade dosing strategies.
免疫检查点抑制已改善转移性黑色素瘤的预后。然而，有限的数据描述了这种治疗方法在心脏移植中的安全性和疗效。新兴的转化和临床证据表明，这些治疗的大部分获益是由初始剂量驱动的，而减弱的剂量方案可能与连续治疗一样有效。
我们提出了一个心脏移植受者伴转移性黑色素瘤的病例，该患者接受了一次 pembrolizumab 治疗后获得了六个月的临床获益，且未发生移植物排斥。
本病例增加了目前关于心脏移植受者应用检查点抑制剂的文献。此外，它探讨了免疫治疗反应的潜在标志物，并支持了更短或个体化免疫检查点阻断剂量策略的潜力。
