{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T16:03:56Z","timestamp":1759939436244,"version":"3.44.0"},"reference-count":20,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,1,20]]},"abstract":"<jats:p>Pembrolizumab is an approved first-line systemic therapy for unresectable metastatic melanoma. Despite the achievement of complete and durable responses in a small subgroup of patients, it is standard practice that pembrolizumab therapy continues beyond complete response. Nevertheless, the incidence of immune-related toxicities gradually increases with continuing pembrolizumab therapy. We report a case highlighting the occurrence of serious induced immune-related adverse events, which were attributed to pembrolizumab in a patient with metastatic melanoma who obtained a complete response (CR) after receiving pembrolizumab for a total of 6.5\u2005months. Although mild pembrolizumab-related toxicity persists, the patient remains disease-free 5.5\u2005months after discontinuation of pembrolizumab. Accordingly, we believe that cessation of pembrolizumab should be considered in patients who achieve a CR because of the ongoing risk of toxicity with extended pembrolizumab administration.<\/jats:p>","DOI":"10.1136\/bcr-2016-218308","type":"journal-article","created":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T06:15:20Z","timestamp":1485929720000},"page":"bcr2016218308","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Risk of cumulative toxicity after complete melanoma response with pembrolizumab"],"prefix":"10.1136","volume":"2017","author":[{"given":"Amy Hsin-Chieh","family":"Hsieh","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Faithfull","sequence":"additional","affiliation":[{"name":"Radiology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,2,1]]},"reference":[{"key":"2025082722255442000_2017.feb01_1.bcr2016218308.1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdv623"},{"key":"2025082722255442000_2017.feb01_1.bcr2016218308.2","first-page":"560","article-title":"Immune checkpoint inhibitors in clinical practice: update on management of immune-related toxicities","volume":"4","author":"Villadolid","year":"2015","journal-title":"Transl Lung Cancer Res"},{"key":"2025082722255442000_2017.feb01_1.bcr2016218308.3","doi-asserted-by":"crossref","unstructured":"Robert C , Ribas AQ , Hamid O , et al . 3-year overall survival for patients with advanced melanoma treated with pembrolizumab in KEYNOTE-001. 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Pembrolizumab versus ipilimumab for advanced melanoma: final overall survival analysis of KEYNOTE-006. J Clin Oncol 2016;34(Suppl; abstr 9504).","DOI":"10.1200\/JCO.2016.34.15_suppl.9504"},{"key":"2025082722255442000_2017.feb01_1.bcr2016218308.13","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1412082"},{"key":"2025082722255442000_2017.feb01_1.bcr2016218308.14","doi-asserted-by":"crossref","first-page":"3479","DOI":"10.18632\/oncotarget.2980","article-title":"PD-1 pathway inhibitors. 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