Evaluation of the response of unresectable primary cutaneous melanoma to immunotherapy visualized with reflectance confocal microscopy: A report of 2 cases Journal Article
| Authors: | Navarrete-Dechent, C.; Cordova, M.; Postow, M. A.; Pulitzer, M.; Lezcano, C.; Halpern, A. C.; Rossi, A. M. |
| Article Title: | Evaluation of the response of unresectable primary cutaneous melanoma to immunotherapy visualized with reflectance confocal microscopy: A report of 2 cases |
| Abstract: | Importance: Melanoma incidence and the use of systemic treatments for it are rising. Current treatment monitoring uses clinical examination and radiologic examinations; however, cutaneous involvement and cutaneous metastasis may not be well visualized. Reflectance confocal microscopy (RCM) is a US Food and Drug Administration-approved, noninvasive technology that enables visualization of the skin with quasihistological resolution. Objective: To evaluate the feasibility of using RCM to monitor advanced melanomas treated with immunotherapy. Design, Setting, and Participants: This case report study took place from March 2017 to June 2018 and included 2 patients with locally advanced melanoma who were not candidates for surgery or were not willing to have surgery and who were started on an immunotherapy regimen at a tertiary care cancer hospital. Main Outcomes and Measures: Clinical and RCM findings correlated with histopathology. Results: In the patients, locally advanced melanoma with cutaneous involvement was treated with immunotherapy (pembrolizumab in 1 patient and an ipilimumab-nivolumab combination in the other) with resulting clearance of the lesions. Use of RCM showed the disappearance of clear melanoma features seen at baseline; these findings correlated with histopathology. The response was not seen with radiologic images, such as magnetic resonance imaging and computed tomography. Conclusions and Relevance: Although RCM will not replace larger field imaging (such as magnetic resonance imaging, positron emission tomography, and computed tomography) in the management and follow-up of melanoma or other tumors, for imaging of cutaneous involvement and disease monitoring, RCM holds promise as a novel noninvasive technique. © 2019 American Medical Association. All rights reserved. |
| Journal Title: | JAMA Dermatology |
| Volume: | 155 |
| Issue: | 3 |
| ISSN: | 2168-6068 |
| Publisher: | American Medical Association |
| Date Published: | 2019-03-01 |
| Start Page: | 347 |
| End Page: | 352 |
| Language: | English |
| DOI: | 10.1001/jamadermatol.2018.3688 |
| PROVIDER: | scopus |
| PUBMED: | 30624578 |
| PMCID: | PMC6440283 |
| DOI/URL: | |
| Notes: | Source: Scopus |
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