title: Response of metastatic mucosal melanoma to immunotherapy: It can get worse before it gets better.
abstract: Immune therapy with checkpoint inhibitors has revolutionized the management of metastatic melanoma. Ipilimumab, nivolumab, and pembrolizumab are all FDA-approved immune checkpoint inhibitors to treat metastatic melanoma. Responses to immune checkpoint inhibitors are usually delayed. An interim progression on restaging computed tomography scans "pseudo-progression" may be observed before response to treatment occur. In this case, we report a significant interim progression of metastatic mucosal melanoma before meaningful responses to immunotherapy occurred. The patient developed significant immune therapy-related colitis and new onset vitiligo. Further restaging computed tomography scans showed sustained tumor response despite stopping the immune therapy.
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Shebli
authors.initials: S
authors.lastname: Atrash
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Issam
authors.initials: I
authors.lastname: Makhoul
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Mizell
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Hutchins
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Fade
authors.initials: F
authors.lastname: Mahmoud
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D000074324:Ipilimumab; D008545:Melanoma / Q000628:therapy*; D008875:Middle Aged; D000077594:Nivolumab
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000074324:Ipilimumab; D000077594:Nivolumab; C582435:pembrolizumab
keywords: Ipilimumab; immunotherapy; mucosal melanoma; pembrolizumab