Successful treatment of multiple in‐transit melanomas on the leg with intensity‐modulated radiotherapy and immune checkpoint inhibitors: Report of two cases

Fujimura, Taku; Kambayashi, Yahiko; Furudate, Sadanori; Hidaka, Takanori; Sato, Yota; Tanita, Kayo; Tono, Hisayuki; Tsukada, Akira; Hashimoto, Akira; Aiba, Setsuya

doi:10.1111/1346-8138.13707

Cited by 14 publications

(13 citation statements)

References 10 publications

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“…For the patients with anti‐PD‐1 Ab‐failed advanced melanoma, ipilimumab is another choice, especially for melanoma without the BRAF gene mutation . However, because the efficacy of ipilimumab in patients with nivolumab‐resistant melanoma is extremely low after objective tumor progression, radiotherapy is sometimes administrated in combination with ipilimumab . Interestingly, Chandra et al .…”

Section: Discussionmentioning

confidence: 99%

“…10 However, because the efficacy of ipilimumab in patients with nivolumab-resistant melanoma is extremely low after objective tumor progression, 5 radiotherapy is sometimes administrated in combination with ipilimumab. 11 Interestingly, Chandra et al 12 reported that ipilimumab increases the abscopal response of low-dose radiotherapy, suggesting that radiotherapy is needed for ipilimumab monotherapy for advanced melanoma without the BRAF gene mutation.…”

Section: Discussionmentioning

confidence: 99%

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Three cases of nivolumab therapy‐failed advanced melanoma successfully controlled by ipilimumab with intensity‐modulated radiotherapy

Amagai

Fujimura

Kambayashi

et al. 2019

The Journal of Dermatology

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Anti‐programmed death 1 antibody monotherapy is a first‐line and widely used immunotherapy for the treatment of advanced melanoma. However, its efficacy rate is lower in the Japanese population compared with the Caucasian population. Ipilimumab is another immune checkpoint inhibitor (ICI) that activates and increases T cells, which suppress the function of regulatory T cells. Previous reports have suggested that ipilimumab is useful for treating advanced melanoma, particularly in combination with radiation therapy. In this report, we described three cases of nivolumab‐resistant melanoma successfully controlled by ipilimumab with intensity‐modulated radiotherapy, which may enhance the therapeutic effects of the sequential administration of ICI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Three cases of nivolumab therapy‐failed advanced melanoma successfully controlled by ipilimumab with intensity‐modulated radiotherapy

Amagai

Fujimura

Kambayashi

et al. 2019

The Journal of Dermatology

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“…Immune checkpoint inhibitors, such as nivolumab and ipilimumab, significantly prolong the overall survival and improve the response rate of unresectable metastatic melanoma [ 1 , 2 , 3 ]. Therefore, the enhancement of antitumor effects of anti-PD-1 antibody has been widely investigated [ 1 , 2 , 3 , 4 , 5 , 6 ]. Indeed, Larkin et al [ 1 ] reported that the rate of overall survival at 3 years was 52% in the nivolumab group and 34% in the ipilimumab group.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Nivolumab-Resistant Multiple In-Transit Melanomas with Ipilimumab and Topical Imiquimod

et al. 2018

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Simultaneous or sequential, planned administration of ipilimumab could significantly enhance the antitumor effects of nivolumab in advanced melanoma patients. On the other hand, the efficacy of ipilimumab for nivolumab-resistant advanced melanoma is extremely poor. Therefore, additional supportive therapy for anti-PD-1 antibody therapy-resistant advanced melanoma has been widely investigated. In this report, we describe a case of multiple in-transit melanomas developing in a nivolumab-resistant patient successfully treated with ipilimumab in combination with imiquimod. Our present case suggested a possible therapy for nivolumab-resistant multiple in-transit melanomas using ipilimumab in combination with topical imiquimod.

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“…In addition, some recent clinical studies showed that the combination of RT and ipilimumab increased the response and survival rates of patients with brain metastasis of melanoma . However, studies on combined anti‐PD‐1 therapy and RT are limited . Moreover, the efficacy of combined RT and anti‐PD‐1 treatment for acral and mucosal melanoma is unclear because of the rarity of these malignancies.…”

Section: Introductionmentioning

confidence: 99%

“…4,8 However, studies on combined anti-PD-1 therapy and RT are limited. [9][10][11][12][13][14] Moreover, the efficacy of combined RT and anti-PD-1 treatment for acral and mucosal melanoma is unclear because of the rarity of these malignancies. Therefore, this study aimed to evaluate the efficacy of combined anti-PD-1 therapy (nivolumab or pembrolizumab) and RT in acral and mucosal melanoma.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of combined radiotherapy and anti‐programmed death 1 therapy in acral and mucosal melanoma

Kato

Hida

Someya

et al. 2019

The Journal of Dermatology

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Some studies showed that clinical response to immune check point inhibitors is lower in acral and mucosal melanoma than in cutaneous melanoma. Although the synergistic effect of radiotherapy (RT) and ipilimumab has been reported in patients with brain metastasis, the efficacy of combined RT and anti‐programmed death 1 (PD‐1) therapy for acral and mucosal melanoma is unclear. The present study aimed to evaluate the efficacy of combined RT and anti‐PD‐1 therapy for acral and mucosal melanoma. We retrospectively analyzed patients with acral or mucosal melanoma who were treated with anti‐PD‐1 and RT at Sapporo Medical University Hospital. In 10 patients (acral, 3; mucosal, 7), the response rate (RR) and the disease control rate (DCR) were 40% and 60%, respectively. As regards mucosal melanoma, four of the seven patients had achieved complete response + partial response, and three had progressive disease (RR = 57.1%). Meanwhile, two of the three patients with acral melanoma had stable disease and one had progressive disease (RR and DCR were 0% and 66.6%, respectively). Except for the patients treated with palliative RT for bone metastasis in the present study, the RR was 50% (4/8 patients), and the DCR was 75% (6/8 patients). Vitiligo developed after RT in five (50%) patients at a median duration of 2 months after RT. The clinical response and the high occurrence of vitiligo suggest that the combination of RT and anti‐PD‐1 therapy could be effective in some patients with mucosal melanoma.

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Successful treatment of multiple in‐transit melanomas on the leg with intensity‐modulated radiotherapy and immune checkpoint inhibitors: Report of two cases

Cited by 14 publications

References 10 publications

Three cases of nivolumab therapy‐failed advanced melanoma successfully controlled by ipilimumab with intensity‐modulated radiotherapy

Three cases of nivolumab therapy‐failed advanced melanoma successfully controlled by ipilimumab with intensity‐modulated radiotherapy

Successful Treatment of Nivolumab-Resistant Multiple In-Transit Melanomas with Ipilimumab and Topical Imiquimod

Efficacy of combined radiotherapy and anti‐programmed death 1 therapy in acral and mucosal melanoma

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