% IMPORTANT: The following is UTF-8 encoded. This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.
@ARTICLE{Thielmann:307523,
author = {C. M. Thielmann$^*$ and J. A. Seier$^*$ and L. Schielke$^*$
and L. J. Albrecht$^*$ and L. Zimmer$^*$ and E.
Livingstone$^*$ and A. Zaremba$^*$ and G. Lodde$^*$ and J.
Dissemond$^*$ and W. Sondermann$^*$ and F. Krefting$^*$ and
A. Tasdogan$^*$ and A. Roesch$^*$ and E. Hadaschik$^*$ and
F. Rambow and K. Griewank$^*$ and S. Ugurel and D.
Schadendorf$^*$ and J.-M. Placke$^*$},
title = {{E}xtracorporeal photopheresis as a therapeutic approach
for treatment resistant immune-related adverse events in
anti-{PD}-1-treated melanoma patients.},
journal = {Frontiers in immunology},
volume = {16},
issn = {1664-3224},
address = {Lausanne},
publisher = {Frontiers Media},
reportid = {DKFZ-2026-00028},
pages = {1727312},
year = {2025},
abstract = {Checkpoint inhibition induced immune-related adverse events
(irAE) may be steroid-dependent or steroid-refractory and
are associated with increased morbidity, mortality and
potentially compromised anti-tumor immunity. Extracorporeal
photopheresis (ECP) has emerged as an alternative for
salvage therapy, however, evidence remains scarce.This
monocenter retrospective study included patients with either
irColitis or irHepatitis, who received ECP after failure or
dependence on high-dose corticosteroids +
infliximab/vedolizumab or mycophenolate mofetil/tacrolimus.
Clinical activity was quantified at least weekly (stool
frequency for colitis; AST/ALT for hepatitis) and primary
endpoint was change in irAE activity over time. Secondary
analyses included steroid-sparing, overall safety, and
melanoma-specific outcomes. Spearman's correlation assessed
irAE severity reduction.Six patients were included in this
study (irColitis n = 4; irHepatitis n = 2; CTCAE ≥ 3).
Extracorporeal photopheresis was started after initial
therapy with corticosteroids and immunosuppression was not
successful. All ECP cycles included two consecutive
treatment days. irAE activity declined promptly after ECP
across patients: irColitis showed strong negative
correlation with time since ECP (rs range -0.88 to -0.97);
irHepatitis displayed parallel ALT/AST declines (rs ≥
-0.92). Corticosteroids were tapered following ECP start
with a median corticosteroid reduction across all patients
to $25\%$ of baseline dose (IQR: 20.7 - 33.3) by week 4 and
to $<5\%$ of baseline dose by week 9 (IQR: 1.6 - 4.7). No
ECP-related adverse events were observed. Accelerated
disease progression was not observed during or after
ECP.This study of six patients with irColitis or irHepatitis
provides evidence that use of ECP is associated with
clinical remission and steroid sparing, while demonstrating
an excellent safety profile and not compromising disease
control. Our data supports the use of ECP as salvage therapy
for steroid- and immunosuppression- refractory irAE in
cancer patients.},
keywords = {Humans / Photopheresis: methods / Male / Female / Middle
Aged / Melanoma: drug therapy / Melanoma: immunology /
Melanoma: therapy / Aged / Retrospective Studies / Immune
Checkpoint Inhibitors: adverse effects / Immune Checkpoint
Inhibitors: therapeutic use / Treatment Outcome / Programmed
Cell Death 1 Receptor: antagonists $\&$ inhibitors /
Programmed Cell Death 1 Receptor: immunology / Adult /
extracorporeal photopheresis (Other) / immune checkpoint
inhibitors (Other) / immune related colitis (Other) / immune
related hepatitis (Other) / melanoma (Other) / Immune
Checkpoint Inhibitors (NLM Chemicals) / Programmed Cell
Death 1 Receptor (NLM Chemicals)},
cin = {ED01},
ddc = {610},
cid = {I:(DE-He78)ED01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41476990},
pmc = {pmc:PMC12748251},
doi = {10.3389/fimmu.2025.1727312},
url = {https://inrepo02.dkfz.de/record/307523},
}