Treatment of metastatic malignant melanoma with vemurafenib - case report

In Slovenia, just like everywhere else in the world, we are witnessing an upward trend in the incidence of malignant melanoma of the skin. According to the data from the 2009 Cancer Registry of Slovenia, Slovenia recorded 298 and 415 new cases of malignant melanoma in the years 2000-2004 and 2005-2009, respectively. It is estimated that in 2012, there were 555 new cases of malignant melanoma. This melanoma is more common in women than in men, and it represents the sixth most common malignancy in women and the eight most common malignancy in men (1). A multidisciplinary approach in the treatment of malignant melanoma is necessary to ensure the best possible outcome for the patient. Collaboration between the dermatologist, surgeon, pathologist, medical oncologist and radiotherapy specialist is important and necessary. The most important are prevention and early detection, because it is crucial to detect the disease soon early, when it is still curable. The higher the stage of the disease at detection, the greater the likelihood of distant metastases when the disease becomes incurable. This happens in more than 50% of patients with stage 3 malignant melanoma. Median survival for metastatic disease is short (6-9 months), and until the use of newer medicines, it rarely exceeded 12 months (2). However, new hope for patients comes with new targeted therapies, such as vemurafenib and ipilimumab, which, according to the currently available data, provide better response rates and prolong the survival of patients with metastatic malignant melanoma as opposed to cytostatic drugs (3, 4). In our clinical case, we present a patient with metastatic malignant melanoma who has been treated with a number of lines and types of systemic therapy, including vemurafenib, a selective inhibitor of the oncogenic BRAFV600E mutant kinase