Rapid complete response of metastatic melanoma in a patient undergoing ipilimumab immunotherapy in the setting of active ulcerative colitis

Journal for ImmunoTherapy of Cancer

Brent A Hanks¹  April K Salama¹  A Doran Bostwick² 

[1] Melanoma Program, Division of Medical Oncology, Department of Internal Medicine, Duke University Medical Center, 203 Research Drive, MSRB1, Room 397, Durham 27710, NC, USA;Departments of Internal Medicine and Pediatrics, Duke University Medical Center, Durham 27710, NC, USA

关键词: Autoimmunity;    Ulcerative colitis;    Advanced melanoma;    Ipilimumab;   

Others  :  1205870
DOI  :  10.1186/s40425-015-0064-2

 received in 2014-12-15, accepted in 2015-04-24,  发布年份 2015

【 摘 要 】

While blockade of the cytotoxic T-lymphocyte antigen-4 (CTLA-4) T cell regulatory receptor has become a commonly utilized strategy in the management of advanced melanoma, many questions remain regarding the use of this agent in patient populations with autoimmune disease. We present a case involving the treatment of a patient with stage IV melanoma and ulcerative colitis (UC) with anti-CTLA-4 antibody immunotherapy. Upon initial treatment, the patient developed grade III colitis requiring tumor necrosis factor-alpha (TNF-α) blocking antibody therapy, however re-treatment with anti-CTLA-4 antibody following a total colectomy resulted in a rapid complete response accompanied by the development of a tracheobronchitis, a previously described extra-intestinal manifestation of UC. This case contributes to the evolving literature on the use of checkpoint inhibitors in patients also suffering from autoimmune disease, supports future clinical trials investigating the use of these agents in patients with autoimmune diseases, and suggests that an understanding of the specific molecular pathways involved in a patient’s autoimmune pathology may provide insight into the development of more effective novel combinatorial immunotherapeutic strategies.

【 授权许可】

   
2015 The Bostwick et al.; licensee BioMed Central.

【 图 表 】

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