Successful Treatment of Myasthenia Gravis Following PD-1/CTLA-4 Combination Checkpoint Blockade in a Patient With Metastatic Melanoma

Frontiers in Oncology

Michael Schroeter¹  Max Schlaak¹  Cornelia Mauch¹  Viola Schweinsberg²  Boris von Reutern³  Michael P. Malter³  Jan-Michael Werner³  Norbert Galldiks⁴  Gereon R. Fink⁴ 

[1] Center of Integrated Oncology, University of Cologne, Cologne, Germany;Department of Dermatology, University of Cologne, Cologne, Germany;Department of Neurology, University of Cologne, Cologne, Germany;Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Juelich, Juelich, Germany;

关键词: nivolumab;    ipilimumab;    myasthenic crisis;    immunotherapy;    checkpoint inhibitor;    neuro-oncology;   

DOI  :  10.3389/fonc.2019.00084

来源: DOAJ

【 摘 要 】

Currently, the blockade of certain immune checkpoints such as the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death-1 (PD-1) using checkpoint inhibitors is standard of care in patients with metastatic melanoma, especially with BRAF wild-type. However, several checkpoint inhibitor-related complications have been reported, including severe adverse events in the central and peripheral nervous system. In particular, in the recent past, the occurrence of myasthenia gravis following checkpoint inhibitor monotherapy, particularly nivolumab or ipilimumab, has been reported. In contrast, reports on PD-1/CTLA-4 combination blockade—usually with fatal clinical outcome—are scarce. We here report a case with combination immune checkpoint blockade-related myasthenia gravis with favorable clinical outcome.

【 授权许可】

Unknown