Table 3.
Focus on late-onset irAEs (>1 year, n = 15) of which 4 late-onset irAES >2 years.
| Type of irAES | Grade | ICI | Delay after ICI Initiation (Days) | Melanoma Characteristics (Type, Mutational Status) | Previous Systemic Treatment (Duration, Days) | Management of irAEs | Time to Recover and Sequelae | |
|---|---|---|---|---|---|---|---|---|
| Case 1 | Pruriginous rash | 3 | Nivo | 374 | MLM, BRAF | Vemurafenib-Cobimetinib (125) | Topical medication + Antihistamine + steroids | No, pruritus persistence |
| Case 2 | Cholestasis | 3 | Nivo | 376 | SSM, wild type | IFNα (94)/Dacarbazine (350)/Ipilimumab (96) | / | Yes, grade I at 156 days |
| Case 3 | Hepatitis | 3 | Nivo | 393 | SSM, wild type | No previous systemic treatment | Steroids per os and Cellcept (500 mgx2 per day) | No, still with steroids and hepatic disurbance when deceased |
| Case 4 | Multiple organ failure | 4 | Nivo | 402 | SSM, NRAS | Pimasertinib (506) | Death before any treatment initiation | No recover |
| Case 5 | Cholestasis | 4 | Nivo | 409 | SSM, wild type | Dacarbazine (192)/Nivolumab (170) | Steroids per os | Yes, at 25 days |
| Case 6 | Immune pneumotitis | 3 | Nivo | 467 | SSM, BRAF | IFNα (534)/Dabrafenib-Tramétinib (89)/Vemurafenib-Cobimetinib (28) | / | Yes, at 44 days |
| Case 7 | Pulmonary embolism | 3 | Nivo | 478 | NM, wild type | IFNα (117)/Ipilimumab (79) | Innohep SC 0.8 mL/day | No recover |
| Case 8 | Apraxia | 3 | Nivo | 499 | SSM, NRAS | Pimasertinib (338)/Ipilimumab (175) | Bolus of steroids IV + Ig IV + Riuximab (4 cures) | No recover: cerebellar syndrome persistence |
| Case 9 | Immune colitis | 3 | Ipi-Nivo | 523 | SSM, NRAS | IFNα (168)/Carboplatine-Dacarbazine (155)/Ipilimumab (156) | Steroids and remicade | Yes, at 72 days |
| Case 10 | Hepatitis and immune colitis | 3 | Nivo | 533 | LMM, wild type | Experimental treatment (Radiotherapy + chloroquine (97))/Ipilimumab (65) | / | Yes, at 25 days |
| Case 11 | Hepatitis | 3 | Nivo | 589 | NM, wild type | IFNα (813)/T-VEC (924)/Nivolumab (182)/Dacarbazine (88) | / | No recover |
| Case 12 | Myocarditis | 4 | Nivo | 759 | SSM, wild type | No previous systemic treatment | Steroids IV 2 mg/kg | No, high troponine persistence |
| Case 13 | Pruritus | 3 | Pembro | 900 | ALM, NRAS | Experimental treatment (MERCK NCT 01866319) (121)/Pembrolizumab (99)/Carboplatine-Dacarbazine (202)/Dacarabzine (338)/Carboplatine-Dacarbazine (57) | Topical medication + Antihistamine + lyrica 300 mg/days | Yes, at 42 days |
| Case 14 | Optic retrobulbar neuritis | 3 | Nivo | 1249 | SSM, NRAS | IFNα (280)/Nivolumab (113)/Dacarbazine (109)/Nivolumab (101)/Experimental treatment (BMS 224-022 Anti-LAG3 + Nivolumab) (532))/Nivolumab (112)/Dacarbazine (140) | Bolus of steroids IV and low dose steroids basal | No recover: visual acuity reduction persistence |
| Case 15 | Hepatitis | 4 | Nivo | 1375 | SSM, wild type | Dacarbazine (192)/Nivolumab (399) | Steroids per os | Yes, at 38 days |