Fingolimod (Gilenya) and melanoma

Area of Science:

• Immunology
• Dermatology
• Oncology

Background:

• Fingolimod, approved by the FDA in 2010 for multiple sclerosis (MS), modulates the immune system.
• Rare instances of melanoma have been reported during clinical trials with fingolimod, with only two published case reports globally, both from Europe.
• Previous research suggests fingolimod may inhibit melanoma growth dependent on vascular endothelial growth factor (VEGF)-induced angiogenesis.

Observation:

• This report describes a case of superficial spreading malignant melanoma.
• The melanoma diagnosis occurred after the patient received fingolimod therapy.
• This is the first reported case of malignant melanoma post-fingolimod therapy in the USA.

Findings:

• The patient developed malignant melanoma subsequent to fingolimod treatment.
• This case highlights a potential association between fingolimod and melanoma development, independent of VEGF pathways.
• The observed melanoma was a superficial spreading type.

Implications:

• Further investigation is warranted to understand the potential oncogenic risk of fingolimod, particularly concerning melanoma.
• Clinicians should be vigilant for skin malignancies in patients undergoing fingolimod therapy.
• This case expands the geographical and clinical understanding of fingolimod-associated melanoma.