Four cases previously treated with ipilimumab with a total of six histologically confirmed symptomatic lesions of RNB without\nany sign of active tumour following stereotactic irradiation of MBM are reported. These lesions were all originally thought to be\ndisease recurrence. In two cases, ipilimumab was given prior to SRT; in the other two ipilimumab was given after SRT.The average\ntime from first ipilimumab to RNB was 15 months. The average time from SRT to RNB was 11 months. The average time from\nfirst diagnosis of MBM to last follow-up was 20 months at which time three patients were still alive, one with no evidence of\ndisease. These cases represent approximately three percent of the total cases of melanoma and ten percent of those cases treated\nwith ipilimumab irradiated in our respective centres collectively. We report this to highlight this new problem so that others may\nhave a high index of suspicion, allowing, if clinically warranted, aggressive surgical salvage, possibly resulting in increased survival.\nFurther studies prospectively collecting data to understand the denominator of this problem are needed to determine whether this\nproblem is just the result of longer survival or whether there is some synergy between these two modalities that are increasingly\nbeing used together.
Loading....