A Case of Amelanotic Melanoma in the Setting of Cemiplimab Therapy for Invasive Squamous Cell Carcinoma

Main Article Content

Victoria Lee
Mark Hoffman
Arlene Ruiz de Luzuriaga

Keywords

amelanotic melanoma, melanoma, squamous cell carcinoma, cemiplimab, immune checkpoint inhibitor, PD-1, immunotherapy

Abstract

Cemiplimab is the first PD-1 inhibitor approved in the United States for the treatment of metastatic or locally advanced cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), but not melanoma. We describe a case of amelanotic melanoma (AM) developing in a patient on cemiplimab therapy for invasive SCC. Cutaneous AM is a rare subtype of cutaneous melanoma that shows little or no melanin pigmentation on clinical and histological examination thus often leading to a high misdiagnosis rate. Physicians should consider atypical presentations of melanoma, including amelanotic melanoma, during surveillance of patients managed with immune checkpoint inhibitor therapy.

References

1. Migden MR, Rischin D, Schmults CD, et al. PD-1 blockade with cemiplimab in advanced cutaneous squamous-cell carcinoma. N Engl J Med 2018; 379(4):341-351.

2. Migden MR, Khushalani NI, Chang ALS, et al. Cemiplimab in locally advanced cutaneous squamous cell carcinoma: results from an open-label, phase 2, single-arm trial. Lancet Oncol 2020; 21(2):294-305.

3. Ahmed SR, Petersen E, Patel R, et al. Cemiplimab-rwlc as first and only treatment for advanced cutaneous squamous cell carcinoma. Expert Rev Clin Pharmacol 2019; 12(10):947-951.

4. Stratigos AJ, Sekulic A, Perris K, et al. Cemiplimab in locally advanced basal cell carcinoma after hedgehog inhibitor therapy: an open-label, multi-centre, single-arm, phase 2 trial. Lancet Oncol 2021; S1470-2045(21):00126-1.

5. Gong H, Zheng H, Li J. Amelanotic melanoma. Melanoma Res 2019; 29(3):221-230.

6. Thomas NE, Kricker , Waxweiler WT, et al. Comparison of clinicopathologic features and survival of histopathologically amelanotic and pigmented melanomas: a population-based study. JAMA Dermatol 2014; 150(12):1306–1314.

7. McClain SE, Mayo KB, Shada AL, et al. Amelanotic melanomas presenting as red skin lesions: a diagnostic challenge with potentially lethal consequences. Int J Dermatol 2012; 51(4):420-426.

8. Clinical Trials Using Cemiplimab [Internet]. National Cancer Institute; n.d. [cited 2021 Jun 2]. Available from: https://www.cancer.gov/about-cancer/treatment/clinical-trials/intervention/cemiplimab

9. Teulings H, Limpens J, Jansen SN, et al. Vitiligo-like depigmentation in patients with stage III-IV melanoma receiving immunotherapy and its association with survival: a systematic review and meta-analysis. J Clin Oncol 2015; 33(7):773-781.
10. Robbins PF, El-Gamil M, Kawakami Y, et al. Recognition of tyrosinase by tumor-infiltrating lymphocytes from a patient responding to immunotherapy. Cancer Res 1994; 54:3124-3126.

11. Long GV, Larkin J, Ascierto PA, et al. PD-L1 expression as a biomarker for nivolumab (NIVO) plus ipilimumab (IPI) and NIVO alone in advanced melanoma (MEL): a pooled analysis. Ann Oncol 2016; 27(6_suppl):1112PD–PD.

12. Kaunitz GJ, Cottrell TR, Lilo M, et al. Melanoma subtypes demonstrate distinct PD-L1 expression profiles. Laboratory Investigation 2017; 97:1063-1071.

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