Atypical severe immune-related adverse effects resulting from sequenced immunotherapy in melanoma.

We report unusual severe toxicity in three patients treated at our institution with sequenced immunotherapy for metastatic melanoma. These three patients illustrate the unusual potential toxicity of sequential administration of anti-programmed cell death 1 followed by ipilimumab, and the need for careful monitoring of these toxicities associated with sequential immunotherapies. Data from forthcoming trials and national databases such as MELBASE, recently implemented in France, will be helpful in providing further insights into the risks and benefits of sequential immunotherapy schedules.