Dr. Luke on Challenges With Immunotherapy in Melanoma

Jason Luke, MD
Published: Monday, Dec 19, 2016



Jason Luke, MD, an assistant professor of Medicine at the University of Chicago Medicine, discusses some of the challenges that oncologists may face when administering immunotherapy agents to patients with melanoma.

According to Luke, there can sometimes be a bit of a learning curve for physicians if they are not that familiar with treating their patients with immunotherapy. One important concern to keep in mind is the possibility of pseudo-progression or delayed response. Though it is relatively rare, this phenomenon has been reported in about 10% to 15% of patients with melanoma, says Luke. His advice is to simply treat the patient for whatever they are presenting with. For example, if a patient comes in and feels well, and there is no evidence of biochemical decline, but a scan reveals progression, the possiblity of delayed response should be considered before taking any other action.

Another unique challenge with immunotherapy is the evaluation of toxicity. Many oncologists are used to side effects of chemotherapy, such as hair loss, fatigue, etc. Patients treated with immunotherapy, on the other hand, experience more autoimmune-like side effects, like colitis, pneumonitis, as well as endocrinological problems such as thyroiditis.


Jason Luke, MD, an assistant professor of Medicine at the University of Chicago Medicine, discusses some of the challenges that oncologists may face when administering immunotherapy agents to patients with melanoma.

According to Luke, there can sometimes be a bit of a learning curve for physicians if they are not that familiar with treating their patients with immunotherapy. One important concern to keep in mind is the possibility of pseudo-progression or delayed response. Though it is relatively rare, this phenomenon has been reported in about 10% to 15% of patients with melanoma, says Luke. His advice is to simply treat the patient for whatever they are presenting with. For example, if a patient comes in and feels well, and there is no evidence of biochemical decline, but a scan reveals progression, the possiblity of delayed response should be considered before taking any other action.

Another unique challenge with immunotherapy is the evaluation of toxicity. Many oncologists are used to side effects of chemotherapy, such as hair loss, fatigue, etc. Patients treated with immunotherapy, on the other hand, experience more autoimmune-like side effects, like colitis, pneumonitis, as well as endocrinological problems such as thyroiditis.



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