[Successful checkpoint inhibition plus extracorporeal photopheresis in patients with metastatic melanoma and advanced Sézary syndrome].

Our case clearly demonstrates the effectiveness of combined therapy with ipilimumab and nivolumab in Sézary syndrome, which, particularly in combination with extracorporeal photopheresis (ECP) and in the context of metastatic melanoma, led to stable partial remission. The feared hyperprogression did not occur. The initial flare was successfully bridged by therapy with topical glucocorticosteroids and a short wait after the first cycle of ipilimumab and nivolumab. Over the longer term, the patient developed an immunotherapy-related lichenoid drug eruption, which ultimately led to a pause in therapy and, thus, possibly to renewed cerebral progression of the melanoma. Further clinical research on the mechanism of action of immune checkpoint inhibitors (ICI) in cutaneous T‑cell lymphoma (CTCL) is needed in order to be able to determine the appropriate patients for ICI before starting therapy. ECP could be a possible combination partner in patients with advanced CTCL.