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Successful treatment with Ipilimumab and Interleukin-2 in two patients with metastatic melanoma and systemic autoimmune disease

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Abstract

Two patients were treated with immunotherapy for metastatic malignant melanoma (MM) despite suffering from systemic autoimmune disease, i.e., ulcerative colitis (UC) and Behcets disease (BD), respectively. Both patients benefitted from the treatment. The patient with UC achieved partial remission of all measurable parameters after treatment with Ipilimumab, while the patient with BD achieved a complete remission of MM after treatment with Interleukin-2 (IL-2) and Interferon-α (IFN-α). Moreover, no aggravation of symptoms related to the autoimmune diseases was seen during treatment, in contrast, clinical indications of improvement were observed. These two cases illustrate that the presence of autoimmune disease does not necessarily predict increased autoimmune toxicity in connection with immunotherapy. They also raise the question of whether autoimmune disease should continue to be an absolute exclusion criterion for treatment of MM with immunotherapy. Consequently, given the poor prognosis of refractory MM, immunotherapies need to be taken into consideration even in cases of autoimmune comorbidity due to the potential long-term benefit that these therapies offer to MM patients.

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Abbreviations

anti-CTLA4:

mAbAnti-cytotoxic T-lymphocyte antigen 4 monoclonal antibody

BD:

Behcets disease

IL-2:

Interleukin-2

IFN-α:

Interferon-α

MM:

Malignant melanoma

UC:

Ulcerative colitis

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The authors have no conflicts of interests to disclose.

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Authors and Affiliations

  1. Department of Haematology and Oncology, Center for Cancer Immune Therapy, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark

    Magnus Pedersen, Rikke Andersen, Per thor Straten & Inge Marie Svane

  2. Department of Oncology, Herlev Hospital, University of Copenhagen, Herlev, Denmark

    Magnus Pedersen, Rikke Andersen & Inge Marie Svane

  3. Department of Pathology, Herlev Hospital, University of Copenhagen, Herlev, Denmark

    Peter Nørgaard

  4. Department of Infectious Diseases and Rheumatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

    Søren Jacobsen

  5. Department of Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark

    Peter Thielsen

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  1. Magnus Pedersen
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Correspondence to Inge Marie Svane.

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Pedersen, M., Andersen, R., Nørgaard, P. et al. Successful treatment with Ipilimumab and Interleukin-2 in two patients with metastatic melanoma and systemic autoimmune disease. Cancer Immunol Immunother 63, 1341–1346 (2014). https://doi.org/10.1007/s00262-014-1607-y

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  • DOI: https://doi.org/10.1007/s00262-014-1607-y

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