289 - Local disease control of nasal malignant melanoma achieved by administration of nivolumab followed by palliative radiation: a case report

Case Summary

A 57-year-old man was diagnosed with locally advanced left nasal malignant melanoma three years ago at another hospital. He had achieved a complete response after receiving heavy particle treatment (57.6 Gy/16 fr) followed by chemotherapy (DAV: dacarbazine, nimustine, vincristine). However, multiple lung metastases were detected by computed tomography (CT) one year ago and he was referred to our hospital. He was treated with four doses of ipilimumab. There was no change in tumor size and he underwent follow-up. He subsequently noticed a swelling of the upper left gingiva at 56 years old. CT revealed multiple metastases in the nasal cavity, maxillary sinus and gingiva, as well as mediastinal lymph node metastasis and progression of the multiple lung metastases. Biopsy of the maxillary sinus showed malignant melanoma. He received seven doses of nivolumab. However, there was local tumor progression and he became anemic due to persistent nasal bleeding. He received palliative radiation (30 Gy/10 fr) for the locally recurrent tumor. Nasal bleeding stopped after radiation and his anemia improved, although there was a mild increase in the size of the lung metastasis. Nivolumab was restarted. Our findings demonstrate that radiation after immunotherapy was effective for controlling nasal malignant melanoma in this patient.

Editorial acknowledgement

Clinical trial identification