ISSN: 2574-7800
Authors: Umefune R, Wakimoto H, Kanzaki A, Shirai K, Kariya T and Kato Y*
Mucosal melanoma is rare, comprising fewer than 2% of all cases of melanoma. Its prognosis is poor, with the five-year survival rate being lower than in patients with cutaneous or uveal melanoma. The current absence of treatment guidelines contributes to the poor prognosis. Immuno-checkpoint inhibitors are known to cause pseudo-progression or immune- related adverse events (irAEs). Herein, we present three cases of mucosal melanoma of the head and neck treated with nivolumab, pembrolizumab, and ipilimumab. All three cases showed pseudo-progression after nivolumab treatment. In Case 3, seronegative rheumatic irAE with multiple muscle pain and arthralgia developed 30 months after nivolumab treatment although serological autoantibodies were negative. The response evaluation criteria in solid tumors (RECIST), which has long been the established method of assessing the treatment response in solid tumors, was ineffective for assessing the efficacy of immunotherapy due to immune-related patterns of response. Additional information concerning the incidence of immune- related responses is necessary to use the immune response criteria for treatment decisions.
Keywords: Mucosal melanoma; Pseudo-progression; Seronegative rheumatic irAE
