Sone Kenbun, Kukita Asako, Masui Yuri, Yamada Daisuke, Shinozaki-Ushiku Aya, Kawata Akira, Taguchi Ayumi, Miyamoto Yuichiro, Tanikawa Michihiro, Iriyama Takayuki, Mori-Uchino Mayuyo, Tsuruga Tetsushi, Osuga Yutaka
Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
Mol Clin Oncol. 2022 Mar;16(3):63. doi: 10.3892/mco.2022.2496. Epub 2022 Jan 17.
In 5% of female patients with malignant melanoma (MM), MM develops from the genital tract. MM of the cervix is particularly rare. In the present case report, a 73-year-old woman with stage ⅢC cervical MM underwent modified radical hysterectomy, bilateral salpingo-oophorectomy and pelvic lymph node dissection. A total of 4 months after surgery, multiple metastases were found in the brain, lung, liver, lymph nodes and bone. The patient underwent γ-knife surgery of the brain and received treatment with anti PD-1 antibodies (nivolumab) and anti-CTLA4 antibodies (ipilimumab); however, they were ineffective and the patient subsequently died. To the best of our knowledge, this is the first report of treatment using two types of immune checkpoint inhibitors administered to a patient with cervical MM. Taken together with previous reports, this case suggests that immune checkpoint inhibitors may be less effective in cervical MM than in cutaneous MM; however, the number of cases is small. Further development of biomarkers to stratify efficacy is required.
在5%的女性恶性黑色素瘤（MM）患者中，MM起源于生殖道。宫颈MM尤为罕见。在本病例报告中，一名患有ⅢC期宫颈MM的73岁女性接受了改良根治性子宫切除术、双侧输卵管卵巢切除术和盆腔淋巴结清扫术。术后4个月，在脑、肺、肝、淋巴结和骨中发现多处转移。该患者接受了脑部伽玛刀手术，并接受了抗PD-1抗体（纳武单抗）和抗CTLA4抗体（伊匹单抗）治疗；然而，治疗无效，患者随后死亡。据我们所知，这是首例对宫颈MM患者使用两种免疫检查点抑制剂进行治疗的报告。结合之前的报告，该病例表明免疫检查点抑制剂在宫颈MM中的疗效可能低于皮肤MM；然而，病例数量较少。需要进一步开发用于分层疗效的生物标志物。
