title: Prolonged survival of a patient with metastatic leptomeningeal melanoma treated with BRAF inhibition-based therapy: a case report.
abstract: BACKGROUND
  Leptomeningeal metastasis of melanoma is a devastating complication with a grave prognosis, and there are no known effective standard treatments. Although selective BRAF inhibitors have demonstrated a significant clinical activity in patients with metastatic melanoma harboring a BRAF mutation, the clinical benefit of BRAF inhibitor-based therapy in leptomeningeal disease is not clear.
  
  
  METHODS
  We present a case of prolonged survival of a patient with BRAF V600E-mutant leptomeningeal disease who was treated with vemurafenib followed by whole brain radiation and a combination of dabrafenib and trametinib. Both vemurafenib and the sequential treatment of radiation and dabrafenib/trametinib led to regression of the leptomeningeal disease, and the patient survived for 19 months after the diagnosis of the leptomeningeal disease.
  
  
  CONCLUSIONS
  This case suggests a possible clinically meaningful benefit of BRAF inhibitor-based therapy and a need for close investigation of this therapeutic approach in patients with this devastating disease.
authors.affiliation: Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. dkim4@mdanderson.org.
authors.forename: Dae Won
authors.initials: DW
authors.lastname: Kim
authors.affiliation: Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. ebarcena@broncs.utpa.edu.
authors.forename: Edelyn
authors.initials: E
authors.lastname: Barcena
authors.affiliation: Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. unmehta@mdanderson.org.
authors.forename: Urvi N
authors.initials: UN
authors.lastname: Mehta
authors.affiliation: Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. mrohlfs@mdanderson.org.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Rohlfs
authors.affiliation: Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. akumar@mdanderson.org.
authors.forename: Ashok J
authors.initials: AJ
authors.lastname: Kumar
authors.affiliation: Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. mpenaspr@mdanderson.org.
authors.forename: Marta
authors.initials: M
authors.lastname: Penas-Prado
authors.affiliation: California Pacific Medical Center for Melanoma Research and Treatment, San Francisco Oncology Associates, 2333 Buchanan St., San Francisco, CA, 94115, USA. kimkb@sutterhealth.org.
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Kim
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism / Q000473:pathology*; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D008875:Middle Aged; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors / Q000235:genetics*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D048493:Proto-Oncogene Proteins B-raf