Cited by 173Cancer Immunotherapy and BiomarkersCutaneous Melanoma Detection and ManagementImmunotherapy and Immune Responses

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Complete response of metastatic melanoma in a patient with Crohn’s disease simultaneously receiving anti-α4β7 and anti-PD1 antibodies

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Frohne, Christopher C., Llano, Ernesto M., Perkovic, Ashley, Cohen, Russell D., Luke, Jason J.·2019·Journal for ImmunoTherapy of Cancer

DOI 10.1186/s40425-018-0484-xPMC PMC6322234

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Abstract

BACKGROUND: Immune checkpoint inhibitors (ICPIs) are increasingly being used in the treatment of a variety of malignancies. The original studies that demonstrated the efficacy of ICPIs excluded patients actively being treated for autoimmune conditions, and there is only limited evidence that these treatments are safe and effective in this population of patients. CASE PRESENTATION: We present a case of a man with Crohn's disease actively requiring immunosuppressive therapy who subsequently received pembrolizumab for metastatic melanoma. He had no further progression of metastatic disease and had resolution of his pulmonary nodule while he experienced no Crohn's disease flares or immune related adverse events. We surveyed the existing literature for studies examining the use of ICPIs in patients with autoimmune disorders and reviewed the unique mechanism of action of the α4β7 inhibitor, vedolizumab. CONCLUSION: Patients with autoimmune conditions should be considered candidates for immune checkpoint inhibition even in the setting of active immunosuppressive therapy. The mechanism of action of immunosuppressive therapy should be considered with the most targeted form of treatment being used when possible. Further prospective studies investigating immunotherapy in patients with autoimmune conditions are warranted.

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Fig. 1 Comparison of Terminal Ileum from Colonoscopy in 2012 to Colonoscopy in 2017, (Left) inflammation of the terminal ileum on colonoscopy in 2012 while on azathioprine and oral/rectal mesalamine. (Right) normal mucosa of the terminal ileum on colonoscopy in May 2017 while on vedolizumabCC BY · PubMed Central

Fig. 2 Resolution of Metastatic Pulmonary Nodule after Treatment with Pembrolizumab, (Left) CT chest from 9/22/2017 revealing RML nodule 1.2 × 1.0 cm in size. (Right) CT chest from 12/14/2017 demonstrating interval resolution of RML nodule after 4 cycles of pembrolizumabCC BY · PubMed Central

Fig. 3 Comparison of Sacral Metastasis Showing No Progression after Treatment with Pembrolizumab and SBRT, (Left) CT abdomen/pelvis sagittal view from 9/22/2017 revealing metastasis in the S1 vertebral body extending posteriorly into the spinal canal. (Right) CT abdomen/pelvis axial view from 12/14/2017 showing unchanged size of sacral metastasisCC BY · PubMed Central

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Authors: Frohne, C. C., Llano, E. M., Perkovic, A., Cohen, R. D., & Luke, J. J.
Affiliations: University of Chicago (US)
Corresponding author: Luke, Jason J.
ORCID: Llano, Ernesto M.
Cohen, Russell D.
Luke, Jason J.
Venue: Journal for ImmunoTherapy of Cancer
Publisher: BMJ
Published: 2019-01-06
Volume: 7
Issue: 1
Pages: 1-1
ISSN: 2051-1426 (ISSN-L)
DOI: 10.1186/s40425-018-0484-x
PMC: PMC6322234
OpenAlex: W2917853396
Cited by: 171
References: 20
Citations by year: 2026: 2 · 2025: 28 · 2024: 25 · 2023: 24 · 2022: 22 · 2021: 42 · 2020: 22 · 2019: 5
FWCI: 9.72
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Journal for ImmunoTherapy of Cancer (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, other-oa)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Department of Defense Career Development Award (W81XWH-17-1-0265)
Topics: Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
Keywords: metastatic melanoma, Crohn's disease, immune checkpoint inhibitors, pembrolizumab, vedolizumab, anti-PD-1, autoimmune disease, immunosuppressive therapy, immune-related adverse events, pulmonary nodules, complete response
MeSH terms: Antineoplastic Combined Chemotherapy Protocols, Crohn Disease, Humans, Immunosuppression Therapy, Male, Melanoma, Middle Aged, Integrins, Treatment Outcome, Programmed Cell Death 1 Receptor, Antibodies, Monoclonal, Humanized

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Complete response of metastatic melanoma in a patient with Crohn’s disease simultaneously receiving anti-α4β7 and anti-PD1 antibodies

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