Journal
IMMUNOTHERAPY
Volume 12, Issue 11, Pages 763-769Publisher
FUTURE MEDICINE LTD
DOI: 10.2217/imt-2019-0004
Keywords
CNS cancer; immunotherapy; leptomeningeal disease; melanoma; PD-1
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Funding
- National Institutes of Health (NIH)/National Cancer Institute (NCI) -Institutional National Research Service Award in Cancer Therapeutics [T32CA193205]
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Background: Leptomeningeal disease (LMD) from melanoma is rapidly fatal with median overall survival between 6.9 weeks and 3.5 months. It is not known whether immune checkpoint inhibitors have a role in treating LMD. Case presentation: We report a 33-year-old male patient who developed LMD from a BRAF V600E-mutated melanoma brain metastasis, despite prior treatment with surgical resection, radiotherapy and dabrafenib/trametinib. He underwent whole brain radiotherapy with stereotactic radiotherapy to the lumbosacral spine, and was started on nivolumab, which led to prolonged remission lasting 2 years and 3 months, before disease progression and death. Conclusion: This is the first case report to highlight a potential long-term efficacy of radiotherapy and anti-PD-1 immunotherapy, in treating LMD from metastatic melanoma that is resistant to targeted therapy.
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