Electrochemotherapy with anti-PD-1 treatment induced durable complete response in heavily pretreated metastatic melanoma patient

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dc.contributor.authorKaraca, Burcak
dc.contributor.authorYayla, Gokce
dc.contributor.authorErdem, Mehmet
dc.contributor.authorGurler, Tahir
dc.date.accessioned2019-10-27T10:42:59Z
dc.date.available2019-10-27T10:42:59Z
dc.date.issued2018
dc.departmentEge Üniversitesien_US
dc.description.abstractMetastatic melanoma (MM) is one of the most lethal types of cancer. Although novel immunotherapeutics have been developed recently, still, these drugs fail to save the lives of a third of MM patients. Electrochemotherapy (ECT) is a local treatment of cancer based on a combination of electroporesis and low-dose chemotherapy. In this case report, we present the treatment history of a MM patient treated successfully with ECT and immunotherapy combination as a fifth-line treatment. Our patient was a 39 year-old woman who was diagnosed with nodulary melanoma stage II. Due to a local recurrence, she was given interferon- treatment. After 6 months, her disease relapsed in the axillary lymph nodes, and temozolamide treatment 150 mg/m2 was initiated. After six cycles on temozolamide, she progressed both in the axillary site and in the lungs. Her BRAF mutation analysis revealed V600E positivity. Hence, BRAF inhibitor-vemurafenib 24 tablets per day was initiated. Within 3 months, she responded dramatically both in the axillary site and in the lungs. At the ninth month of treatment, she progressed again, at which time ipilimumab 3 mg/kg was started as a fourth line treatment. However, shortly after, she progressed again and developed a solitary brain metastasis. She was operated and had whole brain radiotherapy. At that point, nivolumab, an antiprogrammed cell death ligand-1 blocker, was the only remaining option. She showed a biphenotypical response to nivolumab; a mass on the anterior axilla was progressing while the other lymph nodes had regressed. Owing to the accessibility of the subcutaneous lesion with external electrodes, ECT was performed using IGEA Cliniprator device through a hexagonal electrode on the progressive mass, while on nivolumab treatment. A complete response was achieved, with no evidence of disease at 4 years since her local recurrence. Eradication of symptomatic, refractory lesions using ECT meets an important clinical need. Whenever a disseminated disease presents with cutaneous/subcutaneous lesions, high efficacy of ECT should be deployed to augment tumor immunogenicity and complement systemic immunotherapies.en_US
dc.identifier.doi10.1097/CAD.0000000000000580
dc.identifier.endpage196en_US
dc.identifier.issn0959-4973
dc.identifier.issn1473-5741
dc.identifier.issn0959-4973en_US
dc.identifier.issn1473-5741en_US
dc.identifier.issue2en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage190en_US
dc.identifier.urihttps://doi.org/10.1097/CAD.0000000000000580
dc.identifier.urihttps://hdl.handle.net/11454/30710
dc.identifier.volume29en_US
dc.identifier.wosWOS:000427031000010en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofAnti-Cancer Drugsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectanti-PD-1 treatmenten_US
dc.subjectelectrochemotherapyen_US
dc.subjectimmunotherapyen_US
dc.subjectmelanomaen_US
dc.subjectnivolumaben_US
dc.titleElectrochemotherapy with anti-PD-1 treatment induced durable complete response in heavily pretreated metastatic melanoma patienten_US
dc.typeArticleen_US

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