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Immune Checkpoint Inhibitor Therapy as an Eye-Preserving Treatment for Locally Advanced Conjunctival Melanoma
Author(s) -
Bennett Yau Bun Hong,
Joshua R. Ford,
Isabella C. Glitza,
Carlos A. TorresCabala,
Michael T. Tetzlaff,
Víctor G. Prieto,
Richard Parker,
Claire Daniel,
Bita Esmaeli
Publication year - 2020
Publication title -
ophthalmic plastic and reconstructive surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.528
H-Index - 56
eISSN - 1537-2677
pISSN - 0740-9303
DOI - 10.1097/iop.0000000000001700
Subject(s) - medicine , ipilimumab , nivolumab , pembrolizumab , melanoma , immune checkpoint , surgery , oncology , dermatology , immunotherapy , cancer , cancer research
The authors present 2 patients with locally advanced conjunctival melanoma for whom definitive surgery would mean an orbital exenteration with its associated inherent total visual loss and major facial disfigurement. Instead both patients were treated with immune checkpoint inhibitor therapy. In 1 patient neoadjuvant pembrolizumab was used for approximately 12 months and the patient experienced near-total clinical resolution of the conjunctival melanoma. Multiple surgical biopsies of very small residual pigmentation showed pigmented macrophages and a complete pathologic response. In the second patient who presented with a locally advanced and metastatic conjunctival melanoma, significant shrinkage of conjunctival mass was observed after treatment with a combination of ipilimumab and nivolumab for 5 months, and this allowed preservation of the eye and ocular function.

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