Vitiligo in a patient with metastatic melanoma receiving human immunoglobulin G4 monoclonal antibody- nivolumab treatment

Abstract

Nivolumab is an immunotherapy drug developed to increase the ability of the immune system to target and kill cancer cells and is a human immunoglobulin G4 monoclonal antibody blocking programmed cell death-1. Nivolumab is a checkpoint inhibitor that stops a signal that hinders stimulation of the tumor cell-attacking T-cells. It is a relatively new drug used in melanoma treatment. A 67-year-old male patient was operated on for acral lentiginous melanoma and admitted to our outpatient clinic with white spots on his face, head, and back of both hands while receiving nivolumab treatment. New-onset vitiligo during melanoma treatment is associated with more favorable clinical outcomes. Improved survival was demonstrated in this type of patient. Therefore, nivolumab treatment was continued because of new-onset vitiligo in our patient. This patient was living for 4 years without any clinical progression since receiving nivolumab treatment. Hence, this case is reported.