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Challenges in the use of immunotherapy in metastatic melanoma
  1. Ashley Tran1,
  2. Shayna Sarosiek2,
  3. Naomi Y Ko2
  1. 1Boston Medical Center, Boston, Massachusetts, USA
  2. 2Section of Hematology Oncology, Boston University School of Medicine, Boston, Massachusetts, USA
  1. Correspondence to Dr Naomi Ko, naomi.ko{at}


A 65-year-old man with metastatic melanoma was started on immunotherapy, switched to alternative targeted therapy and developed disseminated intravascular coagulation. This case underscores the complexity of interpreting and managing side effects of novel therapies in cancer care, identification of progression versus pseudoprogression and challenges in sequencing treatments in metastatic melanoma.

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  • Contributors AT, SS and NK participated in the patient care. AT and SS wrote the first draft of the manuscript, and NK revised and edited it. All authors approved the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

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