PMC9853440_01
Melanoma history and gene status of the patient at baseline. (A) Immunohistochemistry and (B) next-generation sequencing results of the inguinal region mass biopsy. (C) Contrast-enhanced CT showed enhanced lymph nodes in the right inguinal region and the left cervical region at baseline.
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F1
A 64-year-old female patient who underwent laser therapy because of plantar melanocytic nevus in September 2017 was assessed; after 2 years, in October 2019, an isolated enlarged mass presented in the inguinal region and the pathological biopsy by surgical resection demonstrated lymph node metastatic melanoma (Figure 1A). In addition, microsatellite stability and p.L485-P490 deletion mutation of BRAF were also found in this patient (Figure 1B). In June 2020, an enhanced enlarged lymph node in the right inguinal region and the left cervical region was detected by contrast-enhanced computed tomography (CT), which indicated melanoma metastases (Figure 1C).
Medical imaging examination during the treatment period. (A) Progression disease (PD) confirmed by CT after two cycles of the first-line treatment. (B) Contrast-enhanced abdominal CT showed that the target lesion presented partial response (PR) to the dabrafenib and trametinib combination treatment. (C) Treatment summary of the metastatic melanoma patient with BRAF p.L485-P490 deletion mutations.
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F2
The patient underwent two cycles of anti-programmed cell death 1 (PD-1) with the antibody pembrolizumab (100 mg) as the first-line treatment (Figure 2A). Thus, the patient underwent the combination therapy of dabrafenib (150 mg BID) and trametinib (2 mg QD) as a second-line treatment (Figure 2B). Until the last follow-up in March 2022, the PFS of the patient was over 18 months, and the target lesion still showed a partial response to the combination therapy (Figure 2C).