We recently saw a patient with metastatic melanoma, who is a carrier of Hepatitis B x 30 years, no evidence of cirrhosis, normal LFTs. Her local GI had been following her for 30 years with low levels of detectable virus–had never been treated with antiviral therapy. We had her seen by our hepatology department who started her on temofovir and thought that with active HepB treatment, she should be able to start immunotherapy.
Our plan had been to get her started on Ipi/Nivo combo based on her melanoma.
Have you had any experience with this type of patient?