Hyperprogressive Disease in Anorectal Melanoma Treated by PD-1 Inhibitors

Frontiers in Immunology

Marine Gilabert¹  Philippe Rochigneux²  Daniel Olive³  Marjorie Faure⁴  Isabelle Brenot-Rossi⁵  Sébastien Taix⁶ 

[1] Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Parc Scientifique et Technologique de Luminy, Paoli-Calmettes Institute, Aix-Marseille University, Marseille, France;David Geffen School of Medicine at University of California Los Angeles, Los Angles, CA, United States;Immunomonitoring Plateform, Paoli-Calmettes Institute, Aix-Marseille University, Marseille, France;Medical Oncology Department, Paoli-Calmettes Institute, Aix-Marseille University, Marseille, France;Nuclear Medicine Department, Paoli-Calmettes Institute, Aix-Marseille University, Marseille, France;Pathology Department, Paoli-Calmettes Institute, Aix-Marseille University, Marseille, France;Team Immunity and Cancer, Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM, U1068, CNRS, UMR7258, Paoli-Calmettes Institute, Aix-Marseille University, Marseille, France;

关键词: hyperprogression;    melanoma;    immune checkpoint inhibitors;    immunomonitoring;    anti-PD1;   

DOI  :  10.3389/fimmu.2018.00797

来源: DOAJ

【 摘 要 】

The 5-year survival rate of primary anorectal malignant melanoma is less than 20%. Optimal treatment of this condition remains controversial regarding locally disease, and whether any preferential survival benefit arises from either abdominoperineal resection or wide local excision remains unknown. The majority of patients progress to metastatic disease, and for decades, the use of chemotherapies, such as platines or dacarbazine, has been advocated to improve overall survival. The therapeutic use of new checkpoint inhibitors in a variety of trials has provided evidence for an antitumoral effect of PD-1 and/or CTL4 inhibitors in mucosal melanomas, but these treatments must still be further evaluated. Some anecdotal occurrences of rapid progression [i.e., hyperprogressive disease (HPD)] while using these immune agents have been described, suggesting potentially deleterious effects of these drugs for some patients. We report a 77-year-old male metastatic anorectal melanoma patient presenting with HPD over 2 months of a PD1 inhibitor treatment course and document this HPD blood phenotype.

【 授权许可】

Unknown