Durable complete response in a patient with BRAF-mutated advanced melanoma with ocular and skin toxicities from BRAF/MEK targeted therapy after checkpoint inhibitor treatment: a case report

Here we report the case of a woman suffering from advanced melanoma who developed severe toxicities with BRAF and MEK inhibitors (BRAFis, MEKis), given as second-line therapy after failure of immunotherapy, who achieved a complete and durable response lasting for over 5 years. Significant progress has been achieved in the treatment of advanced melanoma with immune checkpoint inhibitors (ICIs) and targeted therapies using BRAFis and MEKis. While these treatments improve survival, they also pose risks of severe toxicities. Notably, when targeted therapy follows immunotherapy, immune-mediated toxicities may emerge months later due to tumor microenvironment modulation. Despite these risks, both approaches offer a durable response in eligible patients. Further understanding is needed to determine how prior immunotherapy may influence subsequent toxicity risks of target therapy. Understanding these factors could optimize treatment strategies and improve patient outcomes.