Multiple nivolumab-induced CNS demyelination with spontaneous resolution in an asymptomatic metastatic melanoma patient.

Détails

ID Serval
serval:BIB_9C48A9CE403D
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Multiple nivolumab-induced CNS demyelination with spontaneous resolution in an asymptomatic metastatic melanoma patient.
Périodique
Journal for immunotherapy of cancer
Auteur(s)
Pillonel V., Dunet V., Hottinger A.F., Berthod G., Schiappacasse L., Peters S., Michielin O., Aedo-Lopez V.
ISSN
2051-1426 (Electronic)
ISSN-L
2051-1426
Statut éditorial
Publié
Date de publication
02/12/2019
Peer-reviewed
Oui
Volume
7
Numéro
1
Pages
336
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
Publication Status: epublish
Résumé
Immune checkpoint inhibitors (ICPis) have revolutionised the treatment of melanoma by significantly increasing survival rates and disease control. However, ICPis can have specific immune-related adverse events, including rare but severe neurological toxicity.
We report a 44-year-old man diagnosed with stage IIIB melanoma who developed metastatic disease (pulmonary and brain metastases) and was treated with stereotactic radiosurgery and nivolumab immunotherapy. He developed asymptomatic multifocal diffuse white matter lesions consistent with active central nervous system demyelination seen on brain MRI. One month after cessation of the immunotherapy, spontaneous regression of the demyelinating lesions was observed, suggesting a nivolumab-related toxicity.
We report the first case of a melanoma patient with an asymptomatic and spontaneously reversible central nervous system demyelination following nivolumab immunotherapy. This case highlights the need for better recognition of such atypical and rare neurological toxicities which could be mistaken for progressive brain metastases. Early recognition and appropriate management are crucial to reduce severity and duration of these toxicities, especially for patients with less favourable evolution.
Mots-clé
Adult, Antineoplastic Agents, Immunological/administration & dosage, Antineoplastic Agents, Immunological/adverse effects, Asymptomatic Diseases, Demyelinating Diseases/diagnosis, Demyelinating Diseases/etiology, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Melanoma/complications, Melanoma/diagnosis, Melanoma/drug therapy, Nivolumab/administration & dosage, Nivolumab/adverse effects, Remission, Spontaneous, CNS demyelination, Immune checkpoint inhibitors, Immune related adverse events, Metastatic melanoma, Neurological toxicities, Nivolumab
Pubmed
Web of science
Open Access
Oui
Création de la notice
04/12/2019 21:59
Dernière modification de la notice
10/09/2020 5:26
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