Enhanced skin toxicity with concurrent ipilimumab and radiation in vaginal/vulvar melanoma: a case report and literature review

Ipilimumab is a monoclonal cytotoxic T-lymphocyte-associated protein 4 antibody that has demonstrated improved survival in cutaneous melanoma. Little is known about the clinical impact of combining anti-cytotoxic T-lymphocyteassociated protein 4 therapy with radiation. Here we report a case of severe cutaneous desquamation in a 70-year-old female with vaginal/vulvar melanoma receiving concurrent ipilimumab and radiation therapy. The toxicity was successfully treated with oral/topical steroids and a break from treatment. This case underscores the importance of future research on optimal strategies for combining radiation with novel anti-tumour agents.

[1]  H. Mutlu,et al.  Ipilimumab may increase the severity of cutenaous toxicity related to radiotherapy , 2016, Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners.

[2]  F. Patel,et al.  Dosimetric evaluation and clinical outcome in post-operative patients of carcinoma vulva treated with intensity-modulated radiotherapy. , 2015, Indian journal of cancer.

[3]  T. Barnetche,et al.  Immune related adverse events associated with anti-CTLA-4 antibodies: systematic review and meta-analysis , 2015, BMC Medicine.

[4]  P. Ascierto,et al.  Adjuvant ipilimumab versus placebo after complete resection of high-risk stage III melanoma (EORTC 18071): a randomised, double-blind, phase 3 trial. , 2015, The Lancet. Oncology.

[5]  S. Knox,et al.  Immunotherapy and radiation. , 2014, Seminars in oncology.

[6]  S. Demaria,et al.  Combinations of Immunotherapy and Radiation in Cancer Therapy , 2014, Front. Oncol..

[7]  A. Hauschild,et al.  Ipilimumab in patients with cancer and the management of dermatologic adverse events. , 2014, Journal of the American Academy of Dermatology.

[8]  Y. Yamada,et al.  Concurrent Radiotherapy and Ipilimumab Immunotherapy for Patients with Melanoma , 2013, Cancer Immunology Research.

[9]  A. Tarhini Immune-Mediated Adverse Events Associated with Ipilimumab CTLA-4 Blockade Therapy: The Underlying Mechanisms and Clinical Management , 2013, Scientifica.

[10]  D. Heron,et al.  Preoperative intensity modulated radiation therapy and chemotherapy for locally advanced vulvar carcinoma: analysis of pattern of relapse. , 2013, International journal of radiation oncology, biology, physics.

[11]  S. Demaria,et al.  Exploiting the stress response to radiation to sensitize poorly immunogenic tumors to anti-CTLA-4 treatment , 2013, Oncoimmunology.

[12]  H. Burris,et al.  Radiation Recall with Anticancer Agents , 2010, The oncologist.

[13]  S. Demaria,et al.  Systemic effects of local radiotherapy. , 2009, The Lancet. Oncology.

[14]  S. Rosenberg,et al.  Skin reactions in a subset of patients with stage IV melanoma treated with anti-cytotoxic T-lymphocyte antigen 4 monoclonal antibody as a single agent. , 2006, Archives of dermatology.