Immune Checkpoint Inhibitor Therapy as an Eye-Preserving Treatment for Locally Advanced Conjunctival Melanoma.

Abstract

The authors present 2 patients with locally advanced conjunctival melanoma for whom definitive surgery would mean an orbital exenteration with its associated inherent total visual loss and major facial disfigurement. Instead both patients were treated with immune checkpoint inhibitor therapy. In 1 patient neoadjuvant pembrolizumab was used for approximately 12 months and the patient experienced near-total clinical resolution of the conjunctival melanoma. Multiple surgical biopsies of very small residual pigmentation showed pigmented macrophages and a complete pathologic response. In the second patient who presented with a locally advanced and metastatic conjunctival melanoma, significant shrinkage of conjunctival mass was observed after treatment with a combination of ipilimumab and nivolumab for 5 months, and this allowed preservation of the eye and ocular function.

• Authors: Bennett Yau-Bun Hong, Joshua R Ford, Isabella C Glitza, Carlos A Torres Cabala, Michael Tetzlaff, Victor G Prieto, Richard Parker, Claire Daniel, Bita Esmaeli
• Journal: Ophthalmic plastic and reconstructive surgery (Ophthalmic Plast Reconstr Surg) 2021 Jan-Feb 01 Vol. 37 Issue 1 Pg. e9-e13 ISSN: 1537-2677 [Electronic] United States
• PMID: 32618825 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.

Chemical References

• Immune Checkpoint Inhibitors
• Ipilimumab
• Nivolumab

Topics

• Conjunctival Neoplasms (drug therapy)
• Humans
• Immune Checkpoint Inhibitors
• Ipilimumab (therapeutic use)
• Melanoma (drug therapy)
• Nivolumab (therapeutic use)