Kimura Takahiro, Takahama Takayuki, Wakasa Tomoko, Adachi Shiori, Akashi Yusaku, Tamura Takao, Yane Katsunari
Department of Otorhinolaryngology, Kindai University Nara Hospital, Ikoma, Nara 630-0293, Japan.
Department of Medical Oncology, Kindai University Nara Hospital, Ikoma, Nara 630-0293, Japan.
Mol Clin Oncol. 2022 Jan;16(1):2. doi: 10.3892/mco.2021.2435. Epub 2021 Nov 4.
Immune checkpoint inhibitors (ICIs) have markedly changed the treatment landscape for melanoma; however, their efficacy and applications are currently limited and medical requirements remain unmet. The present case study reports on a 85-year-old female patient who visited our outpatient clinic with a 1-month history of a buccal mucosa mass and was diagnosed with locally advanced mucosal melanoma of the head and neck. The patient's tumor progressed right after the administration of nivolumab, compromising oral intake. Palliative debulking surgery was performed. Subsequently, the other part of the melanoma on the hard palate slightly decreased in size without forming new lesions for more than one year after surgery. The present case exemplifies that tumor volume reduction surgery may increase the response to ICI and may prolong the duration of response. This combination therapy may be more effective in patients whose tumors increase in size after administration of ICIs or whose tumor is already large at the beginning of treatment. The combination of ICIs and debulking surgery may become an important treatment option in the future for locally advanced mucosal melanoma.
免疫检查点抑制剂（ICIs）显著改变了黑色素瘤的治疗格局；然而，其疗效和应用目前仍有限，医学需求尚未得到满足。本病例研究报告了一名85岁女性患者，她因颊黏膜肿物1个月前来我院门诊就诊，被诊断为头颈部局部晚期黏膜黑色素瘤。患者在使用纳武单抗后肿瘤立即进展，影响了经口进食。遂进行了姑息性减瘤手术。随后，硬腭上黑色素瘤的另一部分在手术后一年多时间里大小略有减小，且未形成新的病变。本病例表明，肿瘤减容手术可能会增加对ICI的反应，并可能延长反应持续时间。这种联合治疗对于在使用ICIs后肿瘤增大或在治疗开始时肿瘤就已经很大的患者可能更有效。ICIs与减瘤手术的联合可能会成为未来局部晚期黏膜黑色素瘤的一种重要治疗选择。
