Combination Nivolumab/Ipilimumab Immunotherapy For Melanoma With Subsequent Unexpected Cardiac Arrest: A Case Report and Review of Literature
| Autor: | Matthew R.A. Frykenberg, Donita Dyalram, Rania H. Younis, John K Brooks, Petr F Hausner, Zaid H. Khoury, John R. Basile, Cynthia L Idzik-starr |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
0301 basic medicine Oncology Cancer Research medicine.medical_specialty Myocarditis medicine.medical_treatment Immunology Ipilimumab 03 medical and health sciences Antineoplastic Agents Immunological Fatal Outcome 0302 clinical medicine Cancer immunotherapy Internal medicine medicine Humans Immunology and Allergy Melanoma Aged Pharmacology business.industry Mucosal melanoma Immunotherapy medicine.disease Immune checkpoint Heart Arrest Nivolumab 030104 developmental biology 030220 oncology & carcinogenesis business medicine.drug |
| Zdroj: | Journal of Immunotherapy. 42:313-317 |
| ISSN: | 1524-9557 |
| DOI: | 10.1097/cji.0000000000000282 |
| Popis: | The success of immunotherapy in the treatment of patients with advanced melanoma has paved the way for unprecedented successes in the treatment of many other malignancies. We present a case of extensively metastatic oral mucosal melanoma that responded successfully to combined immune checkpoint blockade with ipilimumab and nivolumab but developed multiple immune-related adverse events, including myocarditis, a rare event associated with immunotherapy of elderly melanoma patients. Though the acute myocarditis was managed successfully, the patient succumbed to sudden cardiac death. This case highlights the fact, that autoimmune carditis must be considered when working up the sudden onset of shortness of breath in patients on immune checkpoint blockade. After controlling the acute myocarditis with high-dose steroids, which should be tapered over 6 weeks, further cardiology care is needed, and a defibrillator might have to be implanted. Understanding the pathophysiology of immune-related adverse events could make cancer immunotherapy both more effective and safer. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|