Photo Credit: Stefanamer
The following is a summary of “Safety of immune checkpoint inhibitors after proton beam therapy in head and neck mucosal melanoma: a case series,” published in the December 2023 issue of Dermatology by Uematsu, et al.
Proton beam treatment (PBT) has shown promise in treating locally advanced mucosal melanoma of the head and neck, even though the outlook is not good. Even though PBT might make immune checkpoint inhibitors (ICIs) work better, it has not been proven that ICIs are safe for people who have already had PBT. For a study, researchers sought to examine how safe ICIs were for people with repeat mucosal melanoma after PBT.
They looked at the medical records of people identified with cutaneous or oral melanoma at the National Cancer Center Hospital East between April 2013 and June 2022. Seven people were given ICIs when their head and neck mucosal melanoma (HNMM) came back after PBT. Grade 3 immune-related adverse events (irAEs) happened in four of the seven cases. Two people had grade 3 hypopituitarism because of irAE in the irradiation field. Other grade 3 or higher irAEs included a rise in blood alanine aminotransferase in two patients and gastritis in one.
Because of the irAEs, two patients stopped taking ICI. All irAEs were fixed with the right handling. Giving ICIs after PBT might raise the chance of irAEs, especially in the irradiation field, but they seem doable. The results of this study could help come up with a way to treat locally advanced HNMM that includes PBT and then ICIs.
