Disease stabilization with pembrolizumab for metastatic acral melanoma in the setting of autoimmune bullous pemphigoid

Kristen M. Beck, Joanna Dong, Larisa J. Geskin, Vincent P. Beltrani, Richard G. Phelps, Richard D. Carvajal, Gary Schwartz, Yvonne M. Saenger, Robyn D. Gartrell

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

Background: To date, patients with pre-existing autoimmune conditions have been excluded from immunotherapy trials out of concern for severe autoimmune exacerbations. Case Presentation: We describe the first case of a patient with metastatic cKIT mutated acral melanoma, brain metastasis, and pre-existing severe autoimmune bullous pemphigoid (BP) with stable and asymptomatic disease 10 months after treatment with pembrolizumab. The patient experienced severe BP exacerbation after therapy with ipilimumab requiring systemic immune suppression, but nonetheless pembrolizumab was administered on further disease progression. Conclusions: This case suggests that pembrolizumab may confer more benefit than risk even in patients with known severe autoimmune conditions who require intermittent systemic immunosuppression.

Original languageEnglish (US)
Article number20
JournalJournal for ImmunoTherapy of Cancer
Volume4
Issue number1
DOIs
StatePublished - Apr 19 2016
Externally publishedYes

Keywords

  • Anti-PD1
  • Autoimmunity
  • Bullous pemphigoid
  • Immune-related adverse events [irAEs]
  • Immunotherapy
  • Metastatic Melanoma
  • Pembrolizumab

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Molecular Medicine
  • Oncology
  • Pharmacology
  • Cancer Research

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