ONCAlert | 2018 ASCO Annual Meeting
Melanoma Case Studies

Jason Luke, MD: The Role of LDH, Age, and Sites of Disease in Durability of Response

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

What role might Sarah's LDH, age, and sites of disease play in the durable response that she experienced?

Considering the depth of response and length of durability of the treatment benefit, evaluating the sites of disease and the age of the patient, as well as the LDH status is important. So this is a younger patient, and those patients do tend to do better with these therapies in terms of longer term benefit. And, in terms of sites of disease, that’s also a consideration, and we find that patients that have liver-based metastases are those that we find tend to do less well. So, in a patient who has predominantly cutaneous or subcutaneous lymph node-based disease, those patients do very, very well with targeted therapy and certainly are patients we would want to consider in a situation like this for targeted therapy.

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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