Exclusion criteria vs reality: dual BRAF/MEK inhibition and radiotherapy in a patient with melanoma metastatic to the brain and ECOG 3.
BACKGROUND
Prognosis of metastatic melanoma is changing due to advances in immunotherapy and targeted therapy. However, management of patients with brain metastases in day-to-day practice continues to be a challenge.


METHODS
We describe a 40-year-old woman diagnosed with symptomatic brain metastases from cutaneous melanoma and Eastern Cooperative Oncology Group 3. She was treated, off label, with BRAF inhibitor (dabrafenib) + MEK inhibitor (trametinib) and radiotherapy. There was significant, long-lasting, response (17 months), no clinically relevant toxicity, and clear improvement in quality of life.


CONCLUSIONS
This case is an example of real-life application of advances in targeted therapy.
The Service of Medical Oncology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid - Spain.
Iván
I
Márquez-Rodas
The Service of Dermatology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid - Spain.
Jose-Antonio
JA
Avilés-Izquierdo
The Service of Anatomo-Pathology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid - Spain.
Verónica
V
Parra
The Service of Oncology-Radiotherapy, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid - Spain.
Ana
A
Álvarez-González
The Service of Radio-diagnostics, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid - Spain.
Pedro
P
Borrego
The Service of Radio-diagnostics, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid - Spain.
Pilar
P
Fernández-García
The Service of Radio-diagnostics, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid - Spain.
Juan-Adan
JA
Guzmán-de-Villoria
The Service of Medical Oncology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid - Spain.
Yolanda
Y
Jerez
The Service of Medical Oncology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid - Spain.
Miguel
M
Martin
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008545:Melanoma / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*; D009367:Neoplasm Staging; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors; D018714:Radiotherapy, Adjuvant; D019233:Retreatment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D047428:Protein Kinase Inhibitors; D048493:Proto-Oncogene Proteins B-raf