Brain Metastases Unresponsive to Immunotherapy Detected by 18F-FDG-PET/CT in a Patient with Melanoma
Recently, newer therapies such as immunotherapy have been increasingly used in the treatment of several tumors, including advanced melanoma. In particular, several studies showed that the combination of ipilimumab, an anti-Cytotoxic T-lymphocyte Associated Protein 4 (CTLA-4) monoclonal antibody and...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-06-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/10/6/410 |
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| author | Rosa Fonti Sara Pellegrino Ciro Gabriele Mainolfi Elide Matano Silvana Del Vecchio |
| author_facet | Rosa Fonti Sara Pellegrino Ciro Gabriele Mainolfi Elide Matano Silvana Del Vecchio |
| author_sort | Rosa Fonti |
| collection | DOAJ |
| description | Recently, newer therapies such as immunotherapy have been increasingly used in the treatment of several tumors, including advanced melanoma. In particular, several studies showed that the combination of ipilimumab, an anti-Cytotoxic T-lymphocyte Associated Protein 4 (CTLA-4) monoclonal antibody and nivolumab, an anti-Programmed Death 1 (PD-1) monoclonal antibody, leads to improved survival in patients with metastatic melanoma. Despite that, immunotherapeutic agents may not reach therapeutic concentration in the brain due to the blood–brain barrier. We report the case of a 50-year-old man with advanced melanoma who underwent whole-body 18F-FDG-PET/CT before and after treatment with immunotherapy showing resistant brain metastases confirmed by subsequent MRI of the brain. Moreover, 18F-FDG-PET/CT was able to detect an immune-related adverse event such as enterocolitis that contributed to the worsening of patient conditions. This case shows how a whole-body methodology such as 18F-FDG-PET/CT can be useful in identifying melanoma cancer patients unresponsive to immunotherapy that may benefit from traditional palliative therapy in the effort to improve their quality of life. |
| first_indexed | 2024-03-10T19:07:31Z |
| format | Article |
| id | doaj.art-e8cb198af9274d38b6fe29a0dba15374 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T19:07:31Z |
| publishDate | 2020-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-e8cb198af9274d38b6fe29a0dba153742023-11-20T04:03:59ZengMDPI AGDiagnostics2075-44182020-06-0110641010.3390/diagnostics10060410Brain Metastases Unresponsive to Immunotherapy Detected by 18F-FDG-PET/CT in a Patient with MelanomaRosa Fonti0Sara Pellegrino1Ciro Gabriele Mainolfi2Elide Matano3Silvana Del Vecchio4Institute of Biostructures and Bioimages, National Research Council, Via Tommaso De Amicis 95, 80145 Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, ItalyDepartment of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, ItalyRecently, newer therapies such as immunotherapy have been increasingly used in the treatment of several tumors, including advanced melanoma. In particular, several studies showed that the combination of ipilimumab, an anti-Cytotoxic T-lymphocyte Associated Protein 4 (CTLA-4) monoclonal antibody and nivolumab, an anti-Programmed Death 1 (PD-1) monoclonal antibody, leads to improved survival in patients with metastatic melanoma. Despite that, immunotherapeutic agents may not reach therapeutic concentration in the brain due to the blood–brain barrier. We report the case of a 50-year-old man with advanced melanoma who underwent whole-body 18F-FDG-PET/CT before and after treatment with immunotherapy showing resistant brain metastases confirmed by subsequent MRI of the brain. Moreover, 18F-FDG-PET/CT was able to detect an immune-related adverse event such as enterocolitis that contributed to the worsening of patient conditions. This case shows how a whole-body methodology such as 18F-FDG-PET/CT can be useful in identifying melanoma cancer patients unresponsive to immunotherapy that may benefit from traditional palliative therapy in the effort to improve their quality of life.https://www.mdpi.com/2075-4418/10/6/41018F-FDG-PET/CTmelanomaimmunotherapybrain metastases |
| spellingShingle | Rosa Fonti Sara Pellegrino Ciro Gabriele Mainolfi Elide Matano Silvana Del Vecchio Brain Metastases Unresponsive to Immunotherapy Detected by 18F-FDG-PET/CT in a Patient with Melanoma Diagnostics 18F-FDG-PET/CT melanoma immunotherapy brain metastases |
| title | Brain Metastases Unresponsive to Immunotherapy Detected by 18F-FDG-PET/CT in a Patient with Melanoma |
| title_full | Brain Metastases Unresponsive to Immunotherapy Detected by 18F-FDG-PET/CT in a Patient with Melanoma |
| title_fullStr | Brain Metastases Unresponsive to Immunotherapy Detected by 18F-FDG-PET/CT in a Patient with Melanoma |
| title_full_unstemmed | Brain Metastases Unresponsive to Immunotherapy Detected by 18F-FDG-PET/CT in a Patient with Melanoma |
| title_short | Brain Metastases Unresponsive to Immunotherapy Detected by 18F-FDG-PET/CT in a Patient with Melanoma |
| title_sort | brain metastases unresponsive to immunotherapy detected by 18f fdg pet ct in a patient with melanoma |
| topic | 18F-FDG-PET/CT melanoma immunotherapy brain metastases |
| url | https://www.mdpi.com/2075-4418/10/6/410 |
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