Open AccessSome aspects of nivolumab administration in treatment for metastatic melanoma (clinical cases)
Author(s) -
Л. Ю. Владимирова,
Сторожакова Анна Эдуардовна,
Irina L. Popova,
Sergey N. Kabanov,
Н. А. Абрамова,
М. А. Теплякова,
Н. М. Тихановская,
Kristina А. Novoselova,
А. А. Льянова,
L. A. Ryadinskaya,
В. С. Мягкова,
Faina V. Alieva,
Elena A. Kalabanova,
Я. В. Светицкая,
Н. Ю. Саманева,
Anna V. Tishina
Publication year - 2021
Publication title -
medicinskij sovet
Language(s) - English
Resource type - Journals
eISSN - 2658-5790
pISSN - 2079-701X
DOI - 10.21518/2079-701x-2021-9-64-74
Subject(s) - nivolumab , medicine , melanoma , vitiligo , toxicity , metastatic melanoma , oncology , clinical trial , dermatology , immunotherapy , cancer , cancer research
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.