Discussing Rationale for Combination Therapy in Metastatic Melanoma

Source: Targeted Oncology, October 2023

During a Targeted Oncology™ Case-Based Roundtable™ event, Hussein A. Tawbi, MD, PhD, and participants discussed which first-line therapy they would recommend for a 78-year-old patient with metastatic melanoma and no BRAF-activating mutation. This is the first of 2 articles based on this event.

CASE SUMMARY
A 78-year-old man with a history of stage III melanoma underwent surgical resection 12 years ago; his lymph node dissection (LND) was positive for nodal involvement. The patient declined complete LND and adjuvant systemic therapy. He remained active since his surgery and maintained regular follow-up appointments.

On routine follow-up, the patient presented with moderate asthenia that limited his daily activities. His ECOG performance status was 1, and his physical examination was unremarkable. Notable laboratory findings included lactate dehydrogenase (LDH) level of 380 U/L (reference range, 110-240 U/L). A full-body CT scan revealed pulmonary and hepatic nodules but no evidence of brain metastases. He underwent core-needle biopsy of the largest hepatic lesion in segment IVb without any complications. Pathology revealed metastatic melanoma.

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