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- Title
Therapeutic sequencing in the treatment of BRAF-mutated malignant melanoma: targeted therapy versus immunotherapy – case presentation.
- Authors
Mateianu, Elena Adriana; Stănculeanu, Dana Lucia
- Abstract
Metastatic melanoma is the most aggressive and obstinate type of skin cancer, with poor prognosis. The recent developments in BRAF-targeted therapy and checkpoint inhibitor immunotherapies for metastatic melanoma patients have led to better tolerability, higher objective response rates, and longer survival. Treatment planning has become complex in patients with metastatic BRAF-mutant melanoma: clinicians must weigh various patient factors, including the extent of disease and central nervous system involvement, as well as factors related to the therapeutic agent, such as the rate of clinical response, the durability of response, and the impact on medianand long-term survival. Although targeted therapies generated remarkable and rapid clinical responses in the majority of patients, acquired resistance was developed promptly within months, leading to tumor relapse. By contrast, immunotherapies elicited longterm tumor regression, but the overall response rate was limited. However, pending the results of clinical trials, not only is it currently unclear whether immune checkpoint-inhibitors or targeted therapy should be started up front, but the optimal time for changing treatment, specifically to prevent resistance whilst maintaining disease control, is unknown. In view of the above, we discuss a clinical case of BRAF-mutated melanoma and how can we navigate the treatment decisions for this type of patients.
- Subjects
MELANOMA; CENTRAL nervous system diseases; SKIN cancer; IMMUNOTHERAPY
- Publication
Oncolog-Hematolog, 2020, Issue 52, p45
- ISSN
2066-8716
- Publication type
Article