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Nivolumab with radiation therapy in a glioblastoma patient with Lynch syndrome
  1. Wendy Joyce Sherman1 and
  2. Todd W Vitaz2
  1. 1Department of Neurology and Neurosurgery, Mayo Clinic, Jacksonville, FL, USA
  2. 2Department of Neurosurgery, Spectrum Health, Grand Rapids, MI, USA
  1. Correspondence to Dr Wendy Joyce Sherman; Sherman.Wendy{at}mayo.edu

Abstract

Lynch syndrome is an autosomal dominant disorder leading to cancer predisposition caused by mutations in mismatch repair genes. There is minimal published experience treating glioblastoma in patients with Lynch syndrome. We report a patient with Lynch syndrome who was initially diagnosed with a left occipital isocitrate dehydrogenase (IDH) wild-type glioblastoma. After resection, she was treated with chemoradiation, followed by tumour treating fields. Three years after diagnosis, recurrence was resected. After refusing cytotoxic chemotherapy, decision was made to treat with off-label nivolumab concurrently with radiation. She has been maintained on nivolumab without recurrence of her glioblastoma now over 5 years out from her initial diagnosis. This case provides the first report of glioblastoma in a patient with Lynch syndrome responding to nivolumab and concurrent radiation. In patients with Lynch syndrome and glioblastoma, immunotherapy in the form of nivolumab may be an alternative option to standard cytotoxic chemotherapy.

  • immunological products and vaccines
  • neurology (drugs and medicines)
  • immunology
  • neurooncology
  • CNS cancer

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Footnotes

  • Contributors WJS and TWV both contributed to the acquisition, analysis and interpretation of this work. WJS drafted the work and TWV revised it along with WJS. Both gave the final approval for publication and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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