Complications of sequential immunotherapy in metastatic melanoma

Background Advanced melanoma is associated with a poor prognosis. Targeted therapy and immunotherapy are mainstays of treatment. High-dose interleukin-2 (HD IL-2), interferon alfa-2b, cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors, and programmed cell death protein 1 (PD-1) inhibitors are approved immunotherapies. Genetically engineered T cells targeting melanoma antigens are currently under investigation. Patients with advanced melanoma are often exposed to multiple immunotherapies over their disease course. Adverse implications of sequential use of these therapies is not well described. Here we present a case of a patient with metastatic melanoma who developed rhabdomyolysis and vitiligo after various courses of immunotherapy.