title: Is there still a role for cytotoxic chemotherapy after targeted therapy and immunotherapy in metastatic melanoma? A case report and literature review.
abstract: Metastatic melanoma has long been considered to have a very poor prognosis and to be chemo-resistant. However, a subgroup of patients with metastatic melanoma presents remarkable responses to chemotherapeutic agents, even in the absence of a response to modern targeted therapies and immunotherapies; accordingly, determining predictive biomarkers of the response to chemotherapies for metastatic melanoma remains a priority to guide treatment in these patients. We report a case study of a patient with B-Raf proto-oncogene serine/threonine kinase-mutated metastatic melanoma harbouring many genetic mutations. The patient did not respond to prior targeted therapies or immunotherapies but experienced a dramatic objective radiological and clinical response to subsequent dacarbazine-based chemotherapy. In the era of targeted therapies and immunotherapies for metastatic melanoma, cytotoxic chemotherapies may still represent an interesting therapeutic weapon in a well-defined subgroup of patients presenting with specific genetic and molecular features.
authors.affiliation: Jules Bordet Institute, Free University of Brussels, Brussels, Belgium.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Simon
authors.affiliation: Jules Bordet Institute, Free University of Brussels, Brussels, Belgium. Hampig.kourie@hotmail.com.
authors.forename: Hampig Raphael
authors.initials: HR
authors.lastname: Kourie
authors.affiliation: Jules Bordet Institute, Free University of Brussels, Brussels, Belgium.
authors.forename: Joseph
authors.initials: J
authors.lastname: Kerger
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage* / Q000627:therapeutic use; D003606:Dacarbazine / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000235:genetics; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009154:Mutation; D009362:Neoplasm Metastasis; D000090063:Proto-Oncogene Mas; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; C000715470:MAS1 protein, human; D000090063:Proto-Oncogene Mas; D003606:Dacarbazine; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf
keywords: ATM mutation; Checkpoint inhibitors; Chemosensitivity; Chemotherapy; Immunotherapy; Metastatic melanoma; Vemurafenib