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Sarcoidosis in the setting of combination ipilimumab and nivolumab immunotherapy: a case report & review of the literature
- Source :
- Journal for Immunotherapy of Cancer
- Publication Year :
- 2016
- Publisher :
- BioMed Central, 2016.
-
Abstract
- Background We report a case of sarcoidosis in a patient with metastatic melanoma managed with combination ipilimumab/nivolumab. Sarcoid development has been linked with single agent immunotherapy but, to our knowledge, it has not been reported with combination ipilimumab/nivolumab treatment. This case raises unique management challenges for both the melanoma and the immunotherapy-related toxicity. Case presentation A 46 year old Caucasian female with M1c-metastatic melanoma was managed with ipilimumab/nivolumab combination. Patient experienced response in baseline lesions but developed new clinical and radiographic findings. Biopsy of new lesions at two different sites both demonstrated tumefactive sarcoidosis. Staining of the biopsy tissue for PD-L1 expression demonstrated strong PD-L1 staining of the histiocytes and lymphocytes within the granulomas. Monotherapy nivolumab was continued without progression of sarcoid findings or clinical deterioration. Conclusions Tissue biopsy for evaluation of new lesions on immunotherapy is an important step to help guide decision making, as non-melanoma lesions can mimic disease progression.
- Subjects :
- Cancer Research
Pathology
medicine.medical_specialty
Metastatic melanoma
Sarcoidosis
medicine.medical_treatment
Immunology
Combination immunotherapy
Ipilimumab
Case Report
03 medical and health sciences
0302 clinical medicine
Checkpoint inhibitor
Biopsy
Immune-related adverse event
Immunology and Allergy
Medicine
030212 general & internal medicine
Histiocyte
Pharmacology
medicine.diagnostic_test
business.industry
Melanoma
Immunotherapy
medicine.disease
Dermatology
Nivolumab
Oncology
030220 oncology & carcinogenesis
Molecular Medicine
business
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 20511426
- Volume :
- 4
- Database :
- OpenAIRE
- Journal :
- Journal for Immunotherapy of Cancer
- Accession number :
- edsair.doi.dedup.....ba27363290f645a92be7004b3d112332