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Melanomas arising at uncommon sites include a group of lesions related to unusual localizations in specific ethnic groups. The rarity of the disease often represents a limit to the participation of patients in specific trials. However, this peculiar genetic scenario has important therapeutic implications regarding new oncologic therapies. The aim of this article is to review the clinical features, somatic alterations and therapeutic options for melanomas of uncommon sites. They can be classified as cutaneous and mucosal lesions affecting the nail apparatus, palms/soles, oral mucosa, genital area and scalp. The prognosis may be worse compared to melanomas of other districts, and a prompt diagnosis may dramatically influence the outcome. Dermatologists and oncologists should therefore distinguish this melanoma subgroup in terms of surgical intervention and medical treatment. Due to the lack of mutations in genes usually found in cutaneous melanomas, the discovery of novel targets is required to develop new strategies and to change the prognosis of non-responders or wild-type patients.

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lansoprazole for several years. Systemic high-dose corticosteroid treatment with methylprednisolone 1 mg/kg was promptly initiated along with analgesic therapy, warm saline mouthwashes, intravenous hydration and nutritional support. The patient's general health as well as the mucocutaneous eruption gradually improved. Accordingly, C-reactive protein and aminotransferase levels normalized. Finally, corticosteroid tapering was initiated and she was discharged after 15 days of hospitalization. Nivolumab treatment was permanently discontinued and palliative care was given to the patient.We speculate that the anti-PD1 agent could have triggered an abnormal cytotoxic T lymphocyte response against mucocutaneous tissues in a subject harboring a background of genetic susceptibility due to, in part, single nucleotide polymorphisms variants in immune-related genes.SJS is a highly severe complication of drug administration which may be potentially life-threating if unrecognized and/or misdiagnosed. Although uncommonly, it may follow treatment with anti-PD1 agents. Hence, an increased awareness among oncologists could allow for early recognition and appropriate treatment of nivolumab-induced SJS.

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Background/Aim: Brain metastases are an additional challenge in patients with non-small-cell lung cancer (NSCLC) because most chemotherapy agents cannot cross the bloodbrain barrier. Nivolumab has demonstrated efficacy in patients with advanced squamous NSCLC, but because patients with central nervous system (CNS) metastases are typically excluded from registration trials, 'field-practice' data are needed. Patients and Methods: Patients in the Italian cohort of the Expanded Access Program (EAP) who had CNS metastases at baseline were analyzed. Results: Thirty-seven patients with CNS metastases received a median of six doses of nivolumab. Three patients (8%) had grade 3-4 adverse events and one patient discontinued due to an adverse event. The objective response rate was 19%. Median overall survival was 5.8 (95% confidence interval=1.9-9.8) months and median progressionfree survival was 4.9 (95% confidence interval=2.7-7.1) months. Conclusion: The safety and efficacy of nivolumab in patients with CNS metastases appear to be similar to those seen in the overall EAP cohort in Italy.Squamous non-small-cell lung cancer (NSCLC) is a distinct clinical and pathological subtype of NSCLC, characterized by a high mutation rate and substantial genomic complexity, which may contribute to its poor prognosis (1). Recently, the treatment paradigm for NSCLC has changed with the introduction of immune checkpoint inhibitors (nivolumab, pembrolizumab, and atezolizumab and durvalumab) that block the programmed death-1 (PD-1)/programmed deathligand 1 (PD-L1) pathway and restore the antitumor immune response (2-7).Nivolumab, a fully human PD1 antibody, has been approved in the USA and the European Union for the treatment of patients with locally advanced or metastatic NSCLC whose disease progresses during or after platinumbased chemotherapy (8, 9). Median overall survival (OS) was significantly longer with nivolumab compared to docetaxel in patients who were previously treated for advanced squamous NSCLC in CheckMate 017 [9.2 vs. 6.0 months; hazard ratio for death=0.59; 95% confidence interval (CI)=0.44-0.79; p<0.001] (3), with 2-year OS rates 4265