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Open Access 01-12-2016 | Case report

Selective inhibition of autoimmune exacerbation while preserving the anti-tumor clinical benefit using IL-6 blockade in a patient with advanced melanoma and Crohn’s disease: a case report

Authors: Marc Uemura, Van A. Trinh, Cara Haymaker, Natalie Jackson, Dae Won Kim, James P. Allison, Padmanee Sharma, Luis Vence, Chantale Bernatchez, Patrick Hwu, Adi Diab

Published in: Journal of Hematology & Oncology | Issue 1/2016

Abstract

Background

Novel immunotherapies, or checkpoint inhibitors, targeting programmed cell death protein-1 (PD-1) and cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) have significantly improved outcomes for patients with numerous different cancer types. However, owing to their exclusion from clinical trials and risk for autoimmune exacerbation on these treatments, the impact on safety and degree of toxicity of these potentially life-prolonging therapies is not well characterized in patients with an underlying autoimmune disease or previous organ transplant.

Case presentation

We report a case of a patient with advanced melanoma and refractory Crohn’s disease who was treated concurrently with pembrolizumab (anti-PD-1 antibody) and tocilizumab (anti-interluekin-6 receptor antibody). This novel treatment strategy was well tolerated and did not result in Crohn’s disease exacerbation for at least 16 weeks. Importantly, this treatment resulted in marked, durable antitumor responses.

Conclusions

This outcome suggests that targeted immunosuppression combined with checkpoint inhibitors may hold promise as a treatment strategy for this unique patient population and may warrant additional study.

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Title: Selective inhibition of autoimmune exacerbation while preserving the anti-tumor clinical benefit using IL-6 blockade in a patient with advanced melanoma and Crohn’s disease: a case report
Authors: Marc Uemura
Van A. Trinh
Cara Haymaker
Natalie Jackson
Dae Won Kim
James P. Allison
Padmanee Sharma
Luis Vence
Chantale Bernatchez
Patrick Hwu
Adi Diab
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Journal of Hematology & Oncology / Issue 1/2016
Electronic ISSN: 1756-8722
DOI: https://doi.org/10.1186/s13045-016-0309-7

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