Anti-PD1 following Ipilimumab for mucosal melanoma; durable tumor response associated with severe hypothyroidism and rhabdomyolysis
Menée sur un patient atteint d'un mélanome avancé des muqueuses, cette étude met en évidence des effets indésirables sévères associés à un traitement par anticorps monoclonal anti-PD1
Treatment with fully human monoclonal antibodies against programmed death 1 (anti-PD1) have demonstrated great promise for the treatment of a number of advanced malignancies. While inflammatory adverse events have been well described with anti-Cytotoxic T-Lymphocyte Antigen (CTLA4) therapy, experience with the range of adverse effects of anti-PD1 remains comparatively limited. Here, we report a patient with advanced mucosal melanoma who received four doses of MK-3475, a fully human monoclonal antibody against PD1, and experienced a durable near complete response, but developed severe hypothyroidism, rhabdomyolysis and acute kidney injury. To our knowledge, this is the first case reported of a patient with advanced mucosal melanoma who responded to anti-PD1 therapy. With the promising anti-tumor effects of anti-PD1 in a wide array of tumors, we expect an increasing number of patients to be exposed to anti-PD1 therapies. Recognition of infrequent presentations of adverse events such as elevated CK levels and thyroid disorders in patients who receive anti-PD1 therapy is important.