Skill Checkup: A Man With Metastatic BRAF Wild-Type Melanoma Treated With Anti-PD-1 Monotherapy Reviewed by Maurie Markman, MD

https://reference.medscape.com/viewarticle/cutaneous-metastatic-melanoma-and-wild-braf-2026a1000ws1?src=&_gl=1*zafw5x*_gcl_au*MTA2Mzc5MDEwMS4xNzg5ODMwNjQxLjIxMjk0OTQzNzYuMTc5MjI0MDIyNS4xNzkyMjQwMzE5LjQyODQzNDEwMi4xNzkyMjQwMjI1LjE3OTIyNDAzMTk. A 58-year-old White man in the US with a history of fully resected primary cutaneous melanoma of the back returns for follow-up after 10 months of pembrolizumab monotherapy for biopsy-confirmed metastatic disease involving the liver and mediastinal lymph nodes; he had no objective response at any point during the pembrolizumab treatment course. Restaging CT scan shows growth of the known hepatic lesion and mediastinal adenopathy, with no new sites of disease; he reports no new symptoms and remains fully active (Eastern Cooperative Oncology Group [ECOG] performance status 0). Molecular testing performed at the time of metastatic diagnosis showed no BRAF V600E or V600K mutation. He has no history of autoimmune disease and has tolerated pembrolizumab without immune-related toxicity to date. His oncologist confirms radiographic disease progression and discusses transitioning to a new systemic therapy.