title: Atypical severe immune-related adverse effects resulting from sequenced immunotherapy in melanoma.
abstract: We report unusual severe toxicity in three patients treated at our institution with sequenced immunotherapy for metastatic melanoma. These three patients illustrate the unusual potential toxicity of sequential administration of anti-programmed cell death 1 followed by ipilimumab, and the need for careful monitoring of these toxicities associated with sequential immunotherapies. Data from forthcoming trials and national databases such as MELBASE, recently implemented in France, will be helpful in providing further insights into the risks and benefits of sequential immunotherapy schedules.
authors.affiliation: aAPHP service de dermatologie bAPHP centre d'investigation clinique cAPHP Service de gastro-entérologie, hôpital Saint Louis, Assistance Publique des Hôpitaux de Paris dUniversité Paris Diderot Paris 7, INSERM U976.
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Danlos
authors.forename: Cécile
authors.initials: C
authors.lastname: Pagès
authors.forename: Jennifer
authors.initials: J
authors.lastname: Roux
authors.forename: Majdi
authors.initials: M
authors.lastname: Jebali
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Gornet
authors.forename: Martine
authors.initials: M
authors.lastname: Bagot
authors.forename: Céleste
authors.initials: C
authors.lastname: Lebbé
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D060908:CTLA-4 Antigen / Q000037:antagonists & inhibitors / Q000276:immunology; D006801:Humans; D007154:Immune System Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D007167:Immunotherapy / Q000009:adverse effects*; D000074324:Ipilimumab; D008545:Melanoma / Q000188:drug therapy* / Q000276:immunology; D000077594:Nivolumab; D061026:Programmed Cell Death 1 Receptor / Q000037:antagonists & inhibitors / Q000276:immunology; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000276:immunology; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D060908:CTLA-4 Antigen; C556706:CTLA4 protein, human; D000074324:Ipilimumab; C105992:PDCD1 protein, human; D061026:Programmed Cell Death 1 Receptor; D013256:Steroids; D000077594:Nivolumab; C582435:pembrolizumab