Jason Luke, MD: Second-Line Therapy

Video

If required, what would your second-line therapy be?

In a patient who has a BRAF mutation and initiates dabrafenib/trametinib as frontline therapy to target that mutation, second-line therapy includes multiple options and really becomes clinically dependent — what’s going on with this patient at the time? Unfortunately, we see that a high percentage of patients who initiate targeted therapy towards BRAF subsequently develop brain metastases as their first site of progression. In that context, then radiation is a likely component to your treatment, and we have to think about whether or not steroids are involved. And that then decides if you can use immunotherapy eventually, etc.


CASE: Metastatic Melanoma

Charles, a 62-year-old Caucasian landscaper, presented to his primary care physician with fatigue, dyspnea upon exertion, and a nonproductive cough that has lasted for 6 to 8 weeks. .

  • Following a medical examination, a suspicious mole was biopsied, which resulted in a diagnosis of melanoma.
  • Genetic testing revealed aBRAFV600K mutation
  • PET/CT scan shows metastases to the lung and a soft tissue nodule in the liver (1.4 cm x 1.1 cm)
  • LDH levels and liver function test results were normal
  • The patient’s ECOG performance status was 1

Treatment was initiated with the combination of BRAF and MEK inhibitors.

Related Videos
Michael B. Atkins, MD, an expert on melanoma
Michael B. Atkins, MD, an expert on melanoma
Michael B. Atkins, MD, an expert on melanoma
Michael B. Atkins, MD, an expert on melanoma
Michael B. Atkins, MD, an expert on melanoma
Michael B. Atkins, MD, an expert on melanoma
Michael B. Atkins, MD, an expert on melanoma
Michael B. Atkins, MD, an expert on skin cancer
Hussein Tawbi, MD, PhD, smiling at camera.
Hussein Tawbi, MD, PhD, smiling at camera.
Related Content