Cancer diagnosis & prognosis · 2021
An Autopsy Case of Metastatic Melanoma Originating from the Nasal Cavity That Was Treated With Nivolumab and Ipilimumab.
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Komohara Yoshihiro, Miyamura Tomohiro, Miyashita Azusa, Shigeta Hikaru, Nakagawa Takenobu, Fukushima Satoshi
Аннотация
BACKGROUND: Recent developments in antibodies targeting checkpoint molecules have improved the overall survival of patients with melanoma.
CASE REPORT: A case of metastatic melanoma was treated with antibodies to cytotoxic T-lymphocyte-associated protein 4 and programmed cell death protein 1. Stable disease was achieved but the patient died from systemic metastasis 23 months after the diagnosis of melanoma. An autopsy was performed, and immunohistochemical analysis was carried out using primary melanoma (pre-treatment) and autopsy (post-treatment) samples. The down-regulation of human leukocyte antigen class I and II, melanin, and melanoma antigens was seen in the post-treatment tumor cells. Tumor-infiltrating lymphocyte numbers were significantly reduced in the post-treatment tumor microenvironment. Although programmed death ligand 1 expression was seen in the pre-treatment tumor tissues, it was not seen in the post-treatment tumor tissues.
CONCLUSION: A phenotypical change in the tumor cells was suggested to be associated with the resistance to immune checkpoint inhibitor therapy.
CASE REPORT: A case of metastatic melanoma was treated with antibodies to cytotoxic T-lymphocyte-associated protein 4 and programmed cell death protein 1. Stable disease was achieved but the patient died from systemic metastasis 23 months after the diagnosis of melanoma. An autopsy was performed, and immunohistochemical analysis was carried out using primary melanoma (pre-treatment) and autopsy (post-treatment) samples. The down-regulation of human leukocyte antigen class I and II, melanin, and melanoma antigens was seen in the post-treatment tumor cells. Tumor-infiltrating lymphocyte numbers were significantly reduced in the post-treatment tumor microenvironment. Although programmed death ligand 1 expression was seen in the pre-treatment tumor tissues, it was not seen in the post-treatment tumor tissues.
CONCLUSION: A phenotypical change in the tumor cells was suggested to be associated with the resistance to immune checkpoint inhibitor therapy.