Rechallenge with BRAF and MEK inhibitors in the treatment of metastatic melanoma: A case report with a mini-review

The management of patients with metastatic melanoma remains a difficult clinical problem. Real-world practice of treating patients with encorafenib and binimetinib after progression on combination immunotherapy and combination targeted therapy demonstrates good tolerability and achievements in disease control, including the central nervous system. After progression on chemotherapy, combination targeted therapy, and combination immunotherapy, the patient developed extensive brain and spinal cord lesions and suffered from neurological symptoms (headache, neck pain, back pain, seizures). Rechallenge with BRAFi+MEKi inhibitors and switching to new generation drugs allowed us to achieve disease control, regression of neurological symptoms and a good quality of life for more than 12 months. This clinical case demonstrates the potential efficacy of rechallenge with combination targeted therapy and switching to newer class drugs, which helps achieve a long-term disease control and improve the patient’s quality of life. The article also provides a discussion of possible management strategies for patients who have progressed on currently available BRAFi + MEKi inhibitors.