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Successful Treatment of In-Transit Metastatic Melanoma in a Renal Transplant Patient With Combination T-VEC/Imiquimod Immunotherapy
- Source :
- Journal of Immunotherapy. 43:149-152
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- In the era of immunotherapy for cancer, solid organ transplant patients who go on to develop metastatic or locally advanced melanoma offer particularly difficult challenges. New approaches are needed for these patients. We present a case of in-transit metastatic melanoma in a renal transplant patient. The patient was initially managed with talimogene laherparepvec (T-VEC) injections alone with continued local progression. Addition of topical imiquimod 5% cream to intralesional T-VEC resulted in a rapid and dramatic response, with complete clearance of the cutaneous in-transit metastases and without any sign of organ rejection. In solid organ transplant patients who lack surgical options and are not eligible for treatment with a BRAF inhibitor, and for whom treatment with checkpoint inhibitors present risk of organ rejection, T-VEC either alone or in combination with topical imiquimod should be considered for patients with locally advanced disease. This combination should be a consideration, with close observation, in patients with a history of organ transplantation and immunosuppression.
- Subjects :
- Male
0301 basic medicine
Oncology
Cancer Research
medicine.medical_specialty
Biopsy
medicine.medical_treatment
Immunology
Imiquimod
Herpesvirus 1, Human
Organ transplantation
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Immunology and Allergy
Immune Checkpoint Inhibitors
Melanoma
Oncolytic Virotherapy
Pharmacology
Biological Products
business.industry
Disease Management
Cancer
Immunosuppression
Immunotherapy
Middle Aged
medicine.disease
Combined Modality Therapy
Kidney Transplantation
Transplantation
Treatment Outcome
030104 developmental biology
030220 oncology & carcinogenesis
business
Talimogene laherparepvec
medicine.drug
Subjects
Details
- ISSN :
- 15249557
- Volume :
- 43
- Database :
- OpenAIRE
- Journal :
- Journal of Immunotherapy
- Accession number :
- edsair.doi.dedup.....e00d4a349fc0137b9b9c75e3b587ede9
- Full Text :
- https://doi.org/10.1097/cji.0000000000000319