Published online Apr 6, 2021. doi: 10.12998/wjcc.v9.i10.2373
Peer-review started: November 24, 2020
First decision: December 21, 2020
Revised: December 27, 2020
Accepted: January 27, 2021
Article in press: January 27, 2021
Published online: April 6, 2021
Processing time: 126 Days and 0.2 Hours
Melanoma brain metastasis is a common cause of death in melanoma patients and is associated with a poor prognosis. There are relatively few reports on intracranial infections after brain metastasis resection.
Here we report a case of melanoma brain metastases in a patient harboring a BRAF V600E mutation, who experienced intracranial tumor progression despite previous combined treatment with a programmed death (PD)-1 inhibitor, axitinib, and vemurafenib. She repeatedly underwent local therapy, including stereotactic radiosurgery and intracranial surgery, and developed central nervous system infection. Treatment with vemurafenib combined with cobimetinib resulted in an intracranial progression-free survival of 10 mo. During the coronavirus disease 2019 (COVID-19) pandemic, the patient did not visit the hospital for regular vemurafenib treatment, and experienced intracranial progression after involuntary drug reduction for 1 mo. The patient subsequently received various systemic treatments including vemurafenib, PD-1 inhibitor, and chemotherapy, with an overall survival of 29 mo as of September 2020.
We report the first case of melanoma brain metastases with co-occurring intracranial infection and unintended drug reduction during the COVID-19 outbreak. Long-term control of the intracranial lesions was achieved with systemic and local therapies.
Core Tip: We report a melanoma patient with brain metastases who had long-term control of intracranial lesions with the combination of local therapy and BRAF/MEK inhibitor. During the treatment course, the patient experienced intracranial infection and unwanted drug reduction during the coronavirus disease 2019 outbreak.