Comment on “Maternal and perinatal outcomes in pregnancy-associated melanoma. Report of two cases and a systematic literature review”

Background: Based on favourable outcomes in clinical trials, immune checkpoint inhibitors (ICIs), most notably programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocyte antigen-4 (CTLA-4) inhibitors, are now widely used across multiple cancer types. However, due to their strict inclusion and exclusion criteria, clinical studies often do not address challenges presented by non-trial populations. Design: This review summarises available data on the efficacy and safety of ICIs in trial-ineligible patients, including those with autoimmune disease, chronic viral infections, organ transplants, organ dysfunction, poor performance status, and brain metastases, as well as the elderly, children, and those who are pregnant. In addition, we review data concerning other real-world challenges with ICIs, including timing of therapy switch, relationships to radiotherapy or surgery, re-treatment after an immune-related toxicity, vaccinations in patients on ICIs, and current experience around ICI and coronavirus disease-19. Where possible, we provide recommendations to aid the oftendifficult decision-making process in those settings. Conclusions: Data suggest that ICIs are often active and have an acceptable safety profile in the populations described above, with the exception of PD-1 inhibitors in solid organ transplant recipients. Decisions about whether to treat with ICIs should be personalised and require multidisciplinary input and careful counselling of patients with respect to potential risks and benefits. Clinical judgements need to be carefully weighed, considering factors such as underlying cancer type, feasibility of alternative treatment options, or activity in trial-eligible patients.

show abstract

Immunotherapy use outside clinical trial populations: never say never?

Rzeniewicz

Larkin

Menzies

et al. 2021

Annals of Oncology

View full text Add to dashboard Cite

show abstract

Treatment of metastatic malignant melanoma during pregnancy with a BRAF kinase inhibitor: A case report

Pagan

Jinks

Sewell

2019

Case Reports in Women's Health

View full text Add to dashboard Cite

BackgroundMelanoma accounts for 8% of all malignancies encountered during pregnancy. BRAF kinase inhibitors have shown promise in the treatment of late-stage melanoma; however, there have been no studies and only one previous case report regarding its use in pregnancy.CaseA 25-year-old woman, gravida 1, at 20 weeks of gestation presented to the clinic with a complaint of a lump on her neck and dyspnea. She had had a melanoma that was surgically treated 5 years prior to her pregnancy. A biopsy was performed and she was found to have metastatic melanoma. After multidisciplinary discussion, the patient was offered treatment with vemurafenib, a BRAF kinase inhibitor, and the mass reduced in size.ConclusionMalignancy during pregnancy poses both medical and ethical dilemmas in the management and treatment of cancer. The treatment of late-stage melanoma in pregnancy with a BRAF kinase inhibitor may be an option.

show abstract

Postoperative radiation for primary melanoma of the cervical spinal cord in a pregnant patient: A case report & review of the literature

Stubbs

Vakil

Lewis

et al. 2018

Interdisciplinary Neurosurgery

View full text Add to dashboard Cite

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

hi@scite.ai

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Comment on “Maternal and perinatal outcomes in pregnancy-associated melanoma. Report of two cases and a systematic literature review”

Cited by 6 publications

References 53 publications

Immunotherapy use outside clinical trial populations: never say never?

Immunotherapy use outside clinical trial populations: never say never?

Treatment of metastatic malignant melanoma during pregnancy with a BRAF kinase inhibitor: A case report

Postoperative radiation for primary melanoma of the cervical spinal cord in a pregnant patient: A case report & review of the literature

Contact Info

Product

Resources

About