Concurrent Vogt-Koyanagi-Harada disease and impressive response to immune checkpoint blockade in metastatic melanoma.
Thilo GambichlerC SeifertM LehmannC LukasC ScheelL SusokPublished in: Immunotherapy (2020)
Background: Vogt-Koyanagi-Harada disease (VKHD)-like symptoms have previously been reported in 11 melanoma patients treated with immune checkpoint inhibitors. Materials & methods: We report a female patient with multilocular metastatic melanoma who was treated with nivolumab. Results: Following the first nivolumab dose, she experienced bilateral blurry vision, hearing loss, vertigo and ataxia. Ocular ultrasound was consistent with the diagnosis of uveitis. Audiography revealed severe bilateral sensorineural hearing loss. A high-dose corticosteroid regimen was initiated under which the patient developed generalized vitiligo. Abdominal and thoracic CT scans showed an almost complete response to nivolumab therapy. This patient fulfilled all criteria of VKHD which is characterized pathogenetically by an antimelanocytic autoimmune process. Conclusion: The present case showed an impressive response to antimelanoma immunotherapy. Based on these data, the occurrence of VKHD in melanoma patients appears to be a strong indicator for immune checkpoint inhibitor efficacy.
Keyphrases
- case report
- high dose
- computed tomography
- newly diagnosed
- end stage renal disease
- ejection fraction
- risk assessment
- chronic kidney disease
- multiple sclerosis
- rheumatoid arthritis
- contrast enhanced
- big data
- radiation therapy
- drug induced
- ankylosing spondylitis
- machine learning
- depressive symptoms
- juvenile idiopathic arthritis
- single cell
- spinal cord injury
- ultrasound guided
- locally advanced
- data analysis
- optical coherence tomography
- contrast enhanced ultrasound