Predictive value of basophil-to-lymphocyte and basophil-to-neutrophil ratios in melanoma patients undergoing adjuvant anti-PD-1 treatment

Given the history of irHepatitis during nivolumab treatment, combined immunotherapy (pembrolizumab (200mg) and low-dose ipilimumab (1mg/kg) was introduced due to further disease progression.The patient re-developed irHepatitis (Grade III), but stable disease radiologically.The metastases on the right lower leg were then treated with intralesional electrochemotherapy (bleomycin 30mg), with the aim of achieving loco-regional control.Conclusions: This case highlights the efficacy of multimodal treatment (immuno-, targeted-, chemo-, radio, and intralesional therapy) to maintain disease control over 5 years, despite presenting with Stage IV disease.The potential benefit of re-challenge with immunotherapy has to be weighed against the risk of irAE recurrence on an individual basis.LAG3 inhibition, bispecific molecules (anti-PD-1 and LAG3) und antibody-cytokine fusions (L19IL2 and L19TNF) may represent treatment options in the second-line setting but require evaluation in clinical trials.