Durable remission of sinonasal mucosal melanoma despite early ICI discontinuation and risankizumab treatment for irAEs.
Zarina Brune, Aditya Sharma, Keisuke Shirai
✦ AI-curated · Sources linked
Case in brief
A patient with metastatic sinonasal mucosal melanoma experienced a remarkable and durable response to immune checkpoint inhibitors despite early treatment discontinuation due to severe immune-related adverse events. The patient remained disease-free for over a year while receiving high-dose steroids for Guillain-Barré syndrome and risankizumab for ICI-induced psoriasis and psoriatic arthritis, indicating a unique therapeutic outcome.
What made this case unusual
The case highlights durable remission in metastatic sinonasal mucosal melanoma after limited exposure to immune checkpoint inhibitors, which is atypical given the generally modest responses in mucosal subtypes.
Diagnostic / clinical pearl
Clinicians should consider that severe immune-related adverse events may indicate robust antitumor immunity, potentially leading to durable remission even after discontinuation of immunotherapy.
Why it matters
This case raises important questions about the relationship between immune-related adverse events, immunotherapy efficacy, and long-term disease control in mucosal melanoma, warranting further investigation.