Inoperable bulky melanoma responds to neoadjuvant therapy with vemurafenib. (23rd October 2012)

• Record Type: Journal Article
• Authors: Fadaki, Niloofar; Cardona-Huerta, Servando; Martineau, Lea; Thummala, Suresh; Cheng, Shih-Tsung; Bunker, Steve R; Garcia-Kennedy, Richard; Wang, Wei; Minor, David; Kashani-Sabet, Mohammed; Leong, Stanley P L
• Is Part Of: BMJ case reports. Volume 2012
• Publication Date: 2012-10-23
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2012-007034
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A patient with a bulky inoperable stage IIIC melanoma involving the left axilla and neck from a primary of the left medial elbow received vemurafenib as neo-adjuvant treatment. Based on the molecular analysis, BRAF V600E mutation was present. After 4 months of vemurafinib treatment, the tumours shrank to less than 50% of original clinical size and allowed the surgeons to perform a left modified radical neck dissection and left radical axillary dissection. Pathological analysis of specimen revealed viable metastatic cells only in 1 of 40 nodes resected in the neck and axillary dissection, accounting for over 98% pathological response. Other lymph nodes had a mixture of foamy histiocytic inflammatory reaction fibrosis and islands of necrotic tissues. After recovery from surgery, vemurafenib was resumed and continued for 6 months. He remained disease free 6 months after surgery.