The Community Resource in Targeted Therapies
Driving Knowledge. Empowering Change. Optimizing Outcomes.
ONCAlert | Upfront Therapy for mRCC
Melanoma Case Studies

Jason Luke, MD: Factors to Consider When Determining Treatments

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 factors do you consider when determining treatments for patients like Sarah?

For a patient with low volume disease and normal LDH in the context of an initial diagnosis of metastatic melanoma, if a BRAF mutation is found, those patients appear to be those who derive the greatest benefit from initial targeted therapy. So a patient like Sarah who fills those criteria, especially the low LDH, would certainly be a patient we would want to consider that approach in. As was discussed, she appears to have a long-term durable response and we see from the retrospective data from the clinical trials that, in fact, approximately 30% of patients can have such a long-term durable response. And so this is a perfect patient to consider this sort of approach in the context of tolerability and other options that a patient might consider in terms of side effect profile, etc.

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.

Publications
Copyright © TargetedOnc 2018 Intellisphere, LLC. All Rights Reserved.