Wang Y, Lian B, Cui CL. Long-term control of melanoma brain metastases with co-occurring intracranial infection and involuntary drug reduction during COVID-19 pandemic: A case report. World J Clin Cases 2021; 9(10): 2373-2379 [PMID: 33869616 DOI: 10.12998/wjcc.v9.i10.2373]
Corresponding Author of This Article
Chuan-Liang Cui, MD, Chief Physician, Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Beijing 100142, China. 1008ccl@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 6, 2021; 9(10): 2373-2379 Published online Apr 6, 2021. doi: 10.12998/wjcc.v9.i10.2373
Long-term control of melanoma brain metastases with co-occurring intracranial infection and involuntary drug reduction during COVID-19 pandemic: A case report
Yang Wang, Bin Lian, Chuan-Liang Cui
Yang Wang, Bin Lian, Chuan-Liang Cui, Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, Beijing 100142, China
Author contributions: Wang Y reviewed the literature and contributed to writing the article; Lian B was the patient’s physician and contributed to extracting the data; Cui CL contributed to revising and editing the article; all authors have read and approved the final manuscript.
Supported byBeijing Municipal Administration of Hospitals’ Youth Programme, No. QML20181101; and Beijing Municipal Administration of Hospitals Incubating Program, No. PX2017042.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: No conflicts of interest are declared.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chuan-Liang Cui, MD, Chief Physician, Department of Renal Cancer and Melanoma, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Beijing 100142, China. 1008ccl@163.com
Received: November 24, 2020 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
