Treatment of in-transit and metastatic melanoma in two patients treated with ipilimumab and topical imiquimod
- 1 August 2016
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in Melanoma Research
- Vol. 26 (4), 409-412
- https://doi.org/10.1097/cmr.0000000000000247
Abstract
Checkpoint blockade inhibitors have revolutionized the treatment of metastatic melanoma. Despite the success of these agents in improving the overall survival of patients with metastatic melanoma, not all patients achieve clinical benefit, leaving room for improvement. The presence of cutaneous metastases in patients with metastatic melanoma provides the unique opportunity to treat the cutaneous lesions with a local modality while simultaneously treating systemic disease with systemic therapy. Herein, we describe the treatment of two patients with both in-transit and metastatic melanoma with the combination of the topical toll-like receptor 7 agonist imiquimod with systemic ipilimumab. Both patients appeared to have progressed and developed new cutaneous and systemic metastases while on single agent ipilimumab only to respond when started on topical imiquimod. Both patients tolerated the combination of imiquimod and ipilimumab without serious adverse events, and both patients had excellent clinical responses. These cases provide a proof of principle of the possibility of the combination of toll-like receptor 7 agonists with immune checkpoint blockade inhibitors.Keywords
This publication has 17 references indexed in Scilit:
- Four-year survival rates for patients with metastatic melanoma who received ipilimumab in phase II clinical trialsAnnals of Oncology, 2013
- Safety and Tumor Responses with Lambrolizumab (Anti–PD-1) in MelanomaNew England Journal of Medicine, 2013
- Combined Intralesional Bacille Calmette-Guérin (BCG) and Topical Imiquimod for In-transit MelanomaJournal of Immunotherapy, 2012
- Safety and Activity of Anti–PD-L1 Antibody in Patients with Advanced CancerNew England Journal of Medicine, 2012
- Safety, Activity, and Immune Correlates of Anti–PD-1 Antibody in CancerNew England Journal of Medicine, 2012
- Immunologic Correlates of the Abscopal Effect in a Patient with MelanomaNew England Journal of Medicine, 2012
- Complete regression of subcutaneous and cutaneous metastatic melanoma with high-dose intralesional interleukin 2 in combination with topical imiquimod and retinoid creamMelanoma Research, 2011
- Improved Survival with Ipilimumab in Patients with Metastatic MelanomaNew England Journal of Medicine, 2010
- Small anti-viral compounds activate immune cells via the TLR7 MyD88–dependent signaling pathwayNature Immunology, 2002