To report a case of advanced melanoma managed with strategic rotation and rechallenge of immune checkpoint inhibitors (ICIs) after severe immune-related adverse events (irAEs).
Approach:
Patient Background: A 59-year-old male with advanced nodular melanoma experienced severe irAEs after Nivolumab therapy, leading to treatment cessation.
Treatment Strategy: After resolution of irAEs, the patient was treated with Ipilimumab, followed by a rechallenge with Nivolumab, resulting in complete remission.
Key Findings:
The patient achieved complete remission without recurrence of prior irAEs.
The patient has remained disease-free and off therapy for nearly five years.
Rotation of ICI agents may allow reorganization of the immune repertoire before re-exposure.
Interpretation:
Limitations:
The findings are based on a single case study, limiting generalizability.
Further evidence is needed to establish guidelines for ICI rechallenge after severe irAEs.
