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@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},
}