Ctla-4 blockade with ipilimumab induces significant clinical benefit in a female with melanoma metastases to the cns
Ctla-4 blockade with ipilimumab induces significant clinical benefit in a female with melanoma metastases to the cns"
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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
via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print issues and online access $209.00 per year only $17.42 per issue Learn more Buy
this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS: *
Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Aoyama H _ et al_. (2006) Stereotactic radiosurgery plus whole-brain radiation
therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. _JAMA_ 295: 2483–2491 Article CAS Google Scholar * Kerman AJ _ et al_. (2006)
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patients with metastatic melanoma. _Clin Cancer Res_ 6: 2201–2208 CAS PubMed Google Scholar * Read S _ et al_. (2006) Blockade of CTLA-4 on CD4+CD25+ regulatory T cells abrogates their
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antiglioma immune responses in vivo. _Int J Cancer_ 121: 95–105 Article CAS Google Scholar * Carson MJ _ et al_. (2006) CNS immune privilege: hiding in plain sight. _Immunol Rev_ 213:
48–65 Article Google Scholar * O'Day S and Boasberg P (2006) Management of metastatic melanoma 2005. _Surg Oncol Clin N Am_ 15: 419–437 Article Google Scholar * Attia P _ et al_.
(2005) Autoimmunity correlates with tumor regression in patients with metastatic melanoma treated with anti-cytotoxic T-lymphocyte antigen-4. _J Clin Oncol_ 23: 6043–6053 Article CAS
Google Scholar * Hodi FS _ et al_. (2003) Biologic activity of cytotoxic T lymphocyte-associated antigen 4 antibody blockade in previously vaccinated metastatic melanoma and ovarian
carcinoma patients. _Proc Natl Acad Sci USA_ 100: 4712–4717 Article CAS Google Scholar * Phan GQ _ et al_. (2003) Cancer regression and autoimmunity induced by cytotoxic T
lymphocyte-associated antigen 4 blockade in patients with metastatic melanoma. _Proc Natl Acad Sci USA_ 100: 8372–8377 Article CAS Google Scholar Download references ACKNOWLEDGEMENTS We
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
Google Scholar * Jan Drappatz View author publications You can also search for this author inPubMed Google Scholar * Elsa F Velazquez View author publications You can also search for this
author inPubMed Google Scholar * Nikhil Ramaiya View author publications You can also search for this author inPubMed Google Scholar * Naren Ramakrishna View author publications You can also
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
You can also search for this author inPubMed Google Scholar * Suzanne Mac Rae View author publications You can also search for this author inPubMed Google Scholar * Axel Hoos View author
publications You can also search for this author inPubMed Google Scholar * Martin Mihm View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING
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
2008 * Issue Date: September 2008 * DOI: https://doi.org/10.1038/ncponc1183 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link
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