title: Management of a patient with advanced BRAF-mutant melanoma.
abstract: A 49-year-old man initially diagnosed in 1995 with cutaneous melanoma presented to the authors' institution in 2009 with metastatic, BRAF V600E-mutant melanoma. His treatment course to date has included surgery, adjuvant radiotherapy, and interferon, metastasectomies, granulocyte-macrophage colony-stimulating factors, a clinical trial with the BRAF inhibitor vemurafenib (PLX-4032), clinical trial with combination BRAF plus MEK inhibition with vemurafenib plus GDC-0973, and combination targeted and immune therapy with vemurafenib plus the anti-CTLA4 antibody ipilimumab. This case report illustrates the long-term management of a patient with metastatic melanoma using targeted and immune therapy, evolution in treatment guidelines, next directions in research, and the critical role of clinical trials in advancement of patient care.
authors.affiliation: From Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California.
authors.forename: Michelle T
authors.initials: MT
authors.lastname: Ashworth
authors.forename: Adil
authors.initials: A
authors.lastname: Daud
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D048493:Proto-Oncogene Proteins B-raf