Ctla-4 blockade with ipilimumab induces significant clinical benefit in a female with melanoma metastases to the cns

ABSTRACT BACKGROUND A 63-year-old female presented to her primary physician with numbness and weakness in her left leg, which progressed over several days to involve her entire lower

extremities. MRI of the spine and brain revealed multiple metastases. The patient received ipilimumab and after 3 months experienced intermittent confusion and focal seizures. INVESTIGATIONS

Electroencephalogram and MRI scans of the spine and brain, followed by surgical removal of a left frontal cortical brain metastasis and subsequent histological and pathological analyses.

DIAGNOSIS Metastatic melanoma from an unknown primary tumor. MANAGEMENT The patient was treated with ipilimumab on a compassionate-use program and dexamethasone, celecoxib, and levetiracetam

to treat the symptoms and seizures. Postoperative stereotactic radiosurgery was initiated. Access through your institution Buy or subscribe This is a preview of subscription content, access

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thank Rebecca Turner for editorial assistance. Charles P Vega, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives,

questions and answers of the Medscape-accredited continuing medical education activity associated with this article. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * FS Hodi is Clinical

Director of the Melanoma Program at the Dana–Farber Cancer Institute, Boston, MA, F Stephen Hodi * DA Oble is a Hematopathology Fellow at the Columbia University Medical Center/New York

Presbyterian Hospital, New York, NY, Darryl A Oble * J Drappatz is a Neurologist at Brigham and Women's/Dana–Farber Cancer Center, Boston, MA, USA., Jan Drappatz * EF Velazquez is an

Assistant Professor in the Department of Pathology at Harvard School of Medicine and an Associate Dermatopathologist at the Brigham and Women's Hospital, Boston, MA, USA., Elsa F

Velazquez * N Ramaiya is Clinical Director MRI, at the Dana–Farber Cancer Institute, Boston, MA, USA., Nikhil Ramaiya * N Ramakrishna is Chief of the Division of CNS Radiation Oncology at

Brigham and Women's Hospital and Dana–Farber Cancer Institute, Boston, MA, USA., Naren Ramakrishna * AL Day is Chief of the Department of Neurosurgery at the Brigham and

Women's/Children's Hospitals, Boston, MA, USA., Arthur L Day * A Kruse is a Project Manager for melanoma clinical trials at the Dana–Farber Cancer Institute, Boston, MA, USA.,

Andrea Kruse * S MacRae is the Research Nurse for the Dana–Farber Cancer Institute Melanoma Program, Boston, MA, USA., Suzanne Mac Rae * A Hoos is Medical Lead in Immunology/Oncology at

Bristol-Myers Squibb and is also President of the Cancer Vaccine Consortium and a Member of the Board of Trustees of the Albert B Sabin Vaccine Institute, Boston, MA, USA., Axel Hoos * M

Mihm is Clinical Professor of Dermatology and Pathology at Harvard Medical School and Senior Dermatopathologist at the Massachusetts General Hospital, Boston, MA, USA., Martin Mihm Authors *

F Stephen Hodi View author publications You can also search for this author inPubMed Google Scholar * Darryl A Oble View author publications You can also search for this author inPubMed 

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search for this author inPubMed Google Scholar * Arthur L Day View author publications You can also search for this author inPubMed Google Scholar * Andrea Kruse View author publications

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AUTHOR Correspondence to F Stephen Hodi. ETHICS DECLARATIONS COMPETING INTERESTS FS Hodi is a Consultant and receives grant/research support from Bristol-Myers Squibb. A Hoos is an employee

and stock-holder with Bristol-Myers Squibb. The other authors declared no competing interests. SUPPLEMENTARY INFORMATION SUPPLEMENTARY FIGURE 1 (PDF 877 KB) RIGHTS AND PERMISSIONS Reprints

and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Hodi, F., Oble, D., Drappatz, J. _et al._ CTLA-4 blockade with ipilimumab induces significant clinical benefit in a female with melanoma

metastases to the CNS. _Nat Rev Clin Oncol_ 5, 557–561 (2008). https://doi.org/10.1038/ncponc1183 Download citation * Received: 01 October 2007 * Accepted: 28 May 2008 * Published: 29 July

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