Bilateral Facial Palsy following Ipilimumab Infusion for Melanoma.

M elanoma is the most deadly skin cancer, with 75,000 new diagnoses annually, 15% of which are unresectable. Metastatic melanoma is a devastating diagnosis; before 2011, prognosis had remained relatively unchanged for 40 years and included a 5-year survival rate of 15%. However, in 2011, the Food and Drug Administration approved 2 drugs, ipilimumab and vemurafenib, which proved groundbreaking in treatment of this disease. Ipilimumab (Yervoy) has shown impressive responses in trials, particularly by extending median survival from 6.4 to 10.1 months. Today, ipilimumab is 1 of 6 monoclonal antibodies approved for the treatment of stages III-IV melanoma. Ipilimumab is an anticytotoxic T-lymphocyte antigen 4 recombinant human monoclonal antibody approved for treatment of metastatic melanoma. Cytotoxic T-lymphocyte antigen 4 is expressed on the surface of CD41 and CD81 T cells to prevent inhibitory signals; thus, blockade may enhance T-cell response to cancerous cells. Although these drugs are more effective and have fewer side effects because of their targeted approach, adverse reactions are still possible. Ipilimumab can cause GuillainBarré syndrome, inflammatory myopathy, and acute neuropathy. We report a patient who developed new-onset bilateral facial palsy following infusion of ipilimumab. Exemption was obtained from the University of Cincinnati Institutional Review Board (2015-3264). To our knowledge, facial palsy has never been reported as a side effect of ipilimumab.