Vitiligo in a patient with metastatic melanoma receiving human immunoglobulin G4 monoclonal antibody-nivolumab treatment/Insan immunoglobulin G4 monoklonal antikor-nivolumab tedavisi alan metastatik melanomlu hastada vitiligo

Nivolumab is an immunotherapy drug developed to increase the ability of the immune system to target and kill cancer cells and is a human immunoglobulin G4 monoclonal antibody blocking programmed cell death-1. Nivolumab is a checkpoint inhibitor that stops a signal that hinders stimulation of the tumor cell-attacking T-cells. It is a relatively new drug used in melanoma treatment. A 67-year-old male patient was operated on for acral lentiginous melanoma and admitted to our outpatient clinic with white spots on his face, head, and back of both hands while receiving nivolumab treatment. New-onset vitiligo during melanoma treatment is associated with more favorable clinical outcomes. Improved survival was demonstrated in this type of patient. Therefore, nivolumab treatment was continued because of new-onset vitiligo in our patient. This patient was living for 4 years without any clinical progression since receiving nivolumab treatment. Hence, this case is reported. Keywords: Vitiligo, melanoma, brain metastasis, monoclonal antibody, nivolumab, prognosis, indicator Nivolumab, bagisiklik sisteminin kanser hucrelerini hedefleme ve oldurme yetenegini gelistirmek icin tasarlanmis bir immunoterapi ilacidir ve programlanmis hucre olumu-1'i bloke eden bir insan immunoglobulin G4 monoklonal antikorudur. T-hucrelerinin kanser hucrelerine saldirmasini onleyen bir sinyali bloke eden bir kontrol noktasi inhibitoru olarak calisir. Melanom tedavisinde kullanilan nispeten yeni bir ilactir. Akral lentiginoz melanom nedeniyle opere edilen 67 yasinda erkek hasta, nivolumab tedavisi alirken yuzunde, basinda ve iki elinin arkasinda beyaz lekeler ile poliklinigimize basvurdu. Melanom tedavisi sirasinda yeni baslayan vitiligo, daha olumlu klinik sonuclarla iliskilidir. Bu tip hastalarda artmis sagkalim gosterilmistir. Bu nedenle hastamizda yeni baslayan vitiligo, nivolumab tedavisinde kalmamiza neden oldu. Hasta nivolumab tedavisi aldigindan beri 4 yildir herhangi bir klinik progresyon gostermeden yasiyor. Bu nedenle bu olguyu bildirmek istiyoruz. Anahtar Kelimeler: Vitiligo, melanom, beyin metastazi, monoklonal antikor, nivolumab, prognoz, belirtec