Physicians Discuss Frontline Immunotherapies for Metastatic Melanoma

Source: Targeted Oncology, June 2023

During a Targeted Oncology™ Case-Based Roundtable™ event, Evan J. Lipson, MD, and participants discussed factors influencing their choice of immunotherapy for a patient with BRAF-negative metastatic melanoma.

A 73-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 , 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.