Rapid complete response of metastatic melanoma in a patient undergoing ipilimumab immunotherapy in the setting of active ulcerative colitis.

Journal Article (Journal Article)

While blockade of the cytotoxic T-lymphocyte antigen-4 (CTLA-4) T cell regulatory receptor has become a commonly utilized strategy in the management of advanced melanoma, many questions remain regarding the use of this agent in patient populations with autoimmune disease. We present a case involving the treatment of a patient with stage IV melanoma and ulcerative colitis (UC) with anti-CTLA-4 antibody immunotherapy. Upon initial treatment, the patient developed grade III colitis requiring tumor necrosis factor-alpha (TNF-α) blocking antibody therapy, however re-treatment with anti-CTLA-4 antibody following a total colectomy resulted in a rapid complete response accompanied by the development of a tracheobronchitis, a previously described extra-intestinal manifestation of UC. This case contributes to the evolving literature on the use of checkpoint inhibitors in patients also suffering from autoimmune disease, supports future clinical trials investigating the use of these agents in patients with autoimmune diseases, and suggests that an understanding of the specific molecular pathways involved in a patient's autoimmune pathology may provide insight into the development of more effective novel combinatorial immunotherapeutic strategies.

Full Text

Duke Authors

Cited Authors

  • Bostwick, AD; Salama, AK; Hanks, BA

Published Date

  • 2015

Published In

Volume / Issue

  • 3 /

Start / End Page

  • 19 -

PubMed ID

  • 25992290

Pubmed Central ID

  • PMC4437559

International Standard Serial Number (ISSN)

  • 2051-1426

Digital Object Identifier (DOI)

  • 10.1186/s40425-015-0064-2


  • eng

Conference Location

  • England