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Ipilimumab and nivolumab induced immune-related adverse events in metastatic mucosal melanoma
被引:1
|作者:
Cao, Yenong
[1
]
Afzal, Muhammad Zubair
[2
]
Shirai, Keisuke
[2
]
机构:
[1] Dartmouth Hitchcock Med Ctr, Dept Internal Med, Lebanon, NH 03766 USA
[2] Dartmouth Hitchcock Med Ctr, Norris Cotton Canc Ctr, Lebanon, NH 03766 USA
关键词:
skin cancer;
unwanted effects;
adverse reactions;
D O I:
10.1136/bcr-2021-243713
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
Mucosal melanoma is a rare subtype of melanoma and represents a unique diagnosis and treatment challenge. Immune-checkpoint inhibitors (ICIs) have revolutionised metastatic melanoma treatment, and one of the leading regimens is the combination of ipilimumab (anti-cytotoxic T lymphocyte-associated antigen 4: CTLA4) and nivolumab (anti-programmed cell death protein 1: PD1). We report a case of a patient with metastatic mucosal melanoma treated with ipilimumab and nivolumab who developed multiple immune-related adverse events (irAEs) including uveitis, type I diabetes complicated by diabetic ketoacidosis, destructive thyroiditis, hepatitis and vitiligo. Endocrinopathies including type 1 diabetes and hypothyroidism were treated with insulin and levothyroxine. Hepatitis was responsive to steroids. She had sustained complete response 12 months after discontinuation of the combination therapy. With the wide usage of ICIs in multiple types of malignancies, it is important for general practioners to recognise common and serious irAEs due to ICIs.
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