ONCAlert | 2017 San Antonio Breast Cancer Symposium
Melanoma Case Studies

Jason Luke, MD: The Association Between Durable Response and Low Disease Burden

Jason Luke, MD
Published Online:Aug 17, 2016
Sarah is a 50-year-old Caucasian postal worker who presented to her primary care physician with multiple, skin-colored nodules and palpable lymph nodes. A workup biopsy and mutation test was conducted, which revealed BRAF V600E mutation-positive melanoma that had metastasized to the lymph nodes, subcutaneous tissue, and right adrenal gland. ECOG performance status is 0 and her LDH levels are normal.

Metastatic Melanoma with Jason Luke, MD and Jeffrey Weber, MD, PhD: Case 2

Metastatic Melanoma with Jason Luke, MD and Jeffrey Weber, MD, PhD: Case 1
Metastatic Melanoma with Jason Luke, MD and Jeffrey Weber, MD, PhD: Case 2

Could the durable response for this patient be associated with her low disease burden?

Patients with low disease burden, especially normal LDH, are those who derive the greatest benefit from targeted therapy with BRAF inhibitors, a MEK inhibitor combination such as dabrafenib and trametinib. Certainly, the case is with this patient with those factors being present, we would in fact imply that that’s likely why she did so well. We’re, in the research space now, trying to learn more about what biomarkers we could perhaps evaluate in patients after initiating therapy to predict this beyond clinical factors. But until we have such data and research available, these clinical predictors, again, are a best way of knowing who is likely to respond and do well over a long period of time.

CASE: Metastatic Melanoma

Sarah is a 50-year-old Caucasian postal worker who presented to her primary care physician with multiple, skin-colored nodules and palpable lymph nodes. .

  • A workup, biopsy, and mutation test was conducted, which revealed BRAF V600E mutation-positive melanoma that had metastasized to the lymph nodes, subcutaneous tissue, and right adrenal gland.    
  • ECOG performance status is 0 and her LDH levels are normal.

The patient was started on the combination of dabrafenib and trametinib. She experienced a durable complete response and has remained on therapy for 36 months.

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