Some aspects of nivolumab administration in treatment for metastatic melanoma (clinical cases)

The development of a new direction in anticancer medical therapy – the use of immune checkpoint inhibitors targeting PD-1/ PD-L1 and CTLA-4 – has significantly changed the approach to tumor treatment in the last few years. The PD1 blocker nivolumab in major registered clinical trials improved overal...

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Bibliographic Details
Published in:	Medicinskij sovet no. 9; pp. 64 - 74
Main Authors:	Vladimirova, L. Yu, Storozhakova, A. Eh, Popova, I. L., Kabanov, S. N., Abramova, N. A., Teplyakova, M. A., Tikhanovskaya, N. M., Novoselova, K. A., Lyanova, A. A., Ryadinskaya, L. A., Myagkova, V. S., Alieva, F. V., Kalabanova, E. A., Svetitskaya, Ya. V., Samaneva, N. Yu, Tishina, A. V.
Format:	Journal Article
Language:	English
Published:	Remedium Group LLC 07-08-2021
Subjects:	brain metastases immune checkpoint inhibitors immune-mediated toxicity metastatic melanoma nivolumab vitiligo
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Summary:	The development of a new direction in anticancer medical therapy – the use of immune checkpoint inhibitors targeting PD-1/ PD-L1 and CTLA-4 – has significantly changed the approach to tumor treatment in the last few years. The PD1 blocker nivolumab in major registered clinical trials improved overall survival, including in metastatic melanoma, with a favorable toxicity profile. However, its efficacy in patients with brain metastases from melanoma was poorly studied, since the inclusion criteria for most clinical trials do not envisage recruiting such patients. The immune-mediated toxicity of immune checkpoint inhibitors is currently well enough studied. However, cases of cutaneous toxicity are quite rare and present certain difficulties for differential diagnosis and treatment. This article presents two cases of effective nivolumab treatment in patients with generalized BRAFwt and BRAFmut cutaneous melanoma. The first case is of interest due to the presence of brain metastases in the patient. Nivolumab therapy helped achieving complete regression of intracranial metastases with the long-term effect. The second case, in addition to effective treatment, demonstrates a rare manifestation of skin toxicity – vitiligo on the face and upper extremities.
ISSN:	2079-701X 2658-5790
DOI:	10.21518/2079-701X-2021-9-64-74