PD-1 inhibition in malignant melanoma and lack of clinical response in chronic lymphocytic leukemia in the same patients: a case series

  • I. Landego Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba
  • D. Hewitt CancerCare Manitoba and the University of Manitoba
  • I. Hibbert CancerCare Manitoba
  • D. Dhaliwal Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba
  • W. Pieterse Russell Health Centre
  • D. Grenier Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba
  • R. Wong Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba,
  • J. Johnston CancerCare Manitoba and the University of Manitoba, Rady College of Medicine, Max Rady Faculty of Health Sciences
  • V. Banerji Cancer Care Manitoba, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba
Keywords: CLL. Immunotherapy, Melanoma, chronic lymphocytic leukemia, melanoma

Abstract

Chronic lymphocytic leukemia (CLL) is the most common adult leukemia in the western world. Unfortunately these patients are often immunosuppressed and at increased risk of infection and secondary malignancy. Previous meta-analysis has found that patients with CLL are at a four-fold increase of melanoma compared to the general population. Recent advancements in our understanding of the programmed death (PD) receptor pathway have led to the advent of immunotherapies to target cancer cells. The use of PD-1 inhibitors is now considered first line treatment for BRAF wild-type metastatic melanoma. Interestingly, early pre-clinical data suggest that inhibition of this pathway may also be used in the treatment of CLL, however clinical trials now published were not successful. In this case series we highlight two cases where patients with CLL and concurrent malignant melanoma undergo treatment with PD-1 inhibitors, and were found to have reductions in their WBC counts but these were not sustained. These cases further illustrate that treatment of CLL with PD-1 inhibitors are ineffective treatment alone.

Author Biographies

I. Landego, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba

Department of Internal Medicine

D. Hewitt, CancerCare Manitoba and the University of Manitoba

Research Institute of Oncology and Hematology

I. Hibbert, CancerCare Manitoba

Department of Nursing

D. Dhaliwal, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba

Section of Hematology and Oncology

W. Pieterse, Russell Health Centre

Community Oncology Program

D. Grenier, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba

Section of Hematology and Oncology

R. Wong, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba,

Section of Hematology and Oncology

J. Johnston, CancerCare Manitoba and the University of Manitoba, Rady College of Medicine, Max Rady Faculty of Health Sciences

Section of Hematology and Oncology

V. Banerji, Cancer Care Manitoba, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba

Research Institute of Oncology and Hematology, Section of Hematology and Oncology

Published
2020-02-12
How to Cite
Landego, I., Hewitt, D., Hibbert, I., Dhaliwal, D., Pieterse, W., Grenier, D., Wong, R., Johnston, J., & Banerji, V. (2020). PD-1 inhibition in malignant melanoma and lack of clinical response in chronic lymphocytic leukemia in the same patients: a case series. Current Oncology, 27(3). Retrieved from https://current-oncology.com/index.php/oncology/article/view/5371
Section
Case Report