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Successful Combination Therapy of Nivolumab and Radiation for Massive Mucosal Melanoma in Patient with Autoimmune-Myasthenia Gravis, Systemic Lupus Erythematosus and Rheumatoid Arthritis

¹ Department of Dermatology, Osaka University Graduate School of Medicine, Suita City, Japan
² Department of Dermatology, Osaka University Graduate School of Medicine, Suita City, Japan
³ Department of Dermatology, Osaka University Graduate School of Medicine, Suita City, Japan
⁴ Department of Dermatology, Osaka University Graduate School of Medicine, Suita City, Japan
⁵ Department of Neurology, Osaka University Graduate School of Medicine, Suita City, Japan
⁶ Department of Clinical Immunology, Osaka University Graduate School of Medicine, Suita City, Japan
⁷ Department of Clinical Immunology, Osaka University Graduate School of Medicine, Suita City, Japan
⁸ Department of Neurology, Keio University School of Medicine, Tokyo, Japan
⁹ Department of Dermatology, Osaka University Graduate School of Medicine, Suita City, Japan

Journal of Cosmetics, Dermatological Sciences and Applications·Volume 08 (2018)·Pages 35–38·Published 24 January 2018·DOI10.4236/jcdsa.2018.81006

Abstract

A 58-year-old woman complicated with autoimmune diseases of myasthenia gravis (MG), rheumatoid arthritis, and systemic lupus erythematosus noticed an irregular black macule on her bilateral major labia, which was diagnosed as malignant melanoma. The melanoma lesion involving the vagina, uterus, and ventral side of rectum was not operable and was treated with nivolumab and concurrent radiotherapy with good control of the MG. This resulted in remarkable tumor shrinkage, possibly due to synergistic effects of both treatments. To our knowledge, few reports have described the effectiveness of combination therapy with nivolumab and radiation for malignant melanoma. The present case showed an enhanced anti-tumor effect with combination therapy.

KeywordsAnti PD-1 AntibodyRadiationMalignant MelanomaMyasthenia Gravis

Scott, L.J. (2015) Nivolumab: A Review in Advanced Melanoma. Drugs, 75, 1413-1424. https://doi.org/10.1007/s40265-015-0442-6
Fukushima, S. (2016) A Review of Adverse Events Caused by Immune Checkpoint Inhibitors. Japanese Journal of Clinical Immunology, 39, 30-36. https://doi.org/10.2177/jsci.39.30
Shigeaki, S., Ishikawa, N., Konoeda, F., et al. (2017) Nivolumab-Related Myasthenia Gravis with Myositis and Myocarditis in Japan. Neurology, 89, 1127-1134. https://doi.org/10.1212/WNL.0000000000004359
Shigeaki, S., Utsugisawa, K., Yoshikawa, H., et al. (2009) Autoimmune Targets of Heart and Skeletal Muscles in Myasthenia Gravis. Archives of Neurology, 66, 1334-1338. https://doi.org/10.1001/archneurol.2009.229
Horvat, T.Z. (2015) Immune-Related Adverse Events, Need for Systemic Immunosuppression, and Effects on Survival and Time to Treatment Failure in Patients with Melanoma Treated with Ipilimumab at Memorial Sloan Kettering Cancer Center. Journal of Clinical Oncology, 33, 3193-3198. https://doi.org/10.1200/JCO.2015.60.8448
Baker, C.A. (2014) Combination of Radiation Therapy and Immunotherapy for Melanoma: A Review of Clinical Outcome. International Journal of Radiation Oncology*Biology*Physics, 88, 986-997. https://doi.org/10.1016/j.ijrobp.2013.08.035
Haymaker, C.L. (2017) Metastatic Melanoma Patient Had a Complete Response with Clonal Expansion after Whole Brain Radiation and PD-1 Blockade. Cancer Immunology Miniatures, 5, 100-105. https://doi.org/10.1158/2326-6066.CIR-16-0223
Mohiuddin, M. (2015) High-Dose Radiation as a Dramatic, Immunological Primer in Locally Advanced Melanoma. Cureus, 7, e417. https://doi.org/10.7759/cureus.417

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Successful Combination Therapy of Nivolumab and Radiation for Massive Mucosal Melanoma in Patient with Autoimmune-Myasthenia Gravis, Systemic Lupus Erythematosus and Rheumatoid Arthritis

Abstract

References (8)