Thursday, January 22, 2015

Vitiligo....a good prognostic indicator for melanoma!

Just after my fourth dose of Nivolumab I noticed white patches beginning to develop on my hands.  Previous studies report this form of vitiligo occurs in 5-9% of patients given ipi or anti-PD1.  It can also occur in patients who have taken IL2 as well as spontaneously in the general population. For comparison, its incidence in whites in the United States is 0.4%.  Here's some info I've posted about vitiligo before:  General info about vitiligo and vitiligo in mice with melanoma

A newly published article reviewed human ratties with melanoma, immunotherapy and vitiligo:

Vitiligo-like depigmentation in patients with stage III-IV melanoma receiving immunotherapy and its association with survival:  A systematic review and meta-analysis.  Teulings, Limpen, Jansen, et al.  2015 American Society of Clinical Oncology.

The authors "searched and selected all studies on melanoma immunotherapy that reported on autoimmune toxicity and/or vitiligo between 1995 and 2013."  "One hundred thirty-seven studies....comprising 139 treatment arms....including a total of 5,737 patients.  The overall incidence of vitiligo was 3.4%....vitiligo development was significantly associated with both progression-free survival and overall survival, indicating that these patients have two to four times less risk of disease progression and death, respectively, compared with patients without vitiligo development."

OK all you smart people out there!! Mary Jo Turk....that means you, too!!!  Let's figure out how to make vitiligo happen.  What causes it...really?  How can we induce it in more patients? 

If we can give vitiligo to mice...let's do the same for the human ratties!!!!

vitiligo pics in 2013...I know...weird, right?

Vitiligo pics in 2014

To a whiter shade of pale! - c

3 comments:

  1. Great to hear about the vitiligo. Started a ipi/nivo clinical trial back in mid-April at Emory and my hand has the white blotches.

    Thanks for all your information Celeste and you and the family have a Happy Thanksgiving.

    ReplyDelete