Neoadjuvant Immune Checkpoint Inhibition in Metastatic Conjunctival Melanoma : Ophthalmic Plastic & Reconstructive Surgery

Secondary Logo

Journal Logo

Case Reports

Neoadjuvant Immune Checkpoint Inhibition in Metastatic Conjunctival Melanoma

Fan, Kelly*; Waninger, Jessica J. B.A.*,†; Yentz, Sarah M.D.; McLean, Scott M.D., PH.D.§; Demirci, Hakan M.D.*

Author Information
Ophthalmic Plastic and Reconstructive Surgery 39(5):p e152-e155, September/October 2023. | DOI: 10.1097/IOP.0000000000002407

The development of immune checkpoint inhibitors (ICI) has transformed the treatment of advanced-stage cutaneous melanoma; however, most trials did not include patients with conjunctival melanoma. Herein the authors describe a patient with recurrent conjunctival melanoma who developed locally advanced, b-raf and v-raf murine sarcoma viral oncogene homolog B1-negative melanoma in her nasal cavity and extensive, metabolically active, bilateral lymphadenopathy in her thorax. Her nasal mass measured 4.3 × 1.7 cm and was determined to be unresectable. She was treated with 4 cycles of combination ipilimumab and nivolumab therapy followed by maintenance nivolumab. She experienced a dramatic treatment response with a reduction in the size of her nasal mass to 3.0 × 1.1 cm and a complete resolution of her adenopathy. She then underwent complete surgical resection of her residual mass (approximately 75% of her original tumor size) and remains melanoma-free at 1 year of follow-up. Given the underlying genetic similarities of conjunctival melanoma to cutaneous melanoma, providers should consider the use of neoadjuvant immune checkpoint inhibitors for patients with locally advanced or limited metastatic disease.

© 2023 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.

You can read the full text of this article if you:

Access through Ovid