BRAFV600E Metastatic Melanoma Journey: A Perspective from a Patient and his Oncologist

This article is co-authored by a patient with BRAFV600E metastatic melanoma and his treating oncologist. The patient describes how he coped with his diagnosis and treatment. He details the pathway of his melanoma treatment, which has spanned over 10 years, including surgical interventions, medical treatment, and participation in clinical trials. He relates his experience of living with the disease—and the adverse effects of treatment—in the long term. The clinical perspective of his treating oncologist reviews the diagnostic process and explains how the therapeutic options were selected for and with the patient. The oncologist also addresses the integration of the patient into clinical trials involving programmed death-1 (PD-1) inhibitors and BRAF/MEK inhibitors. Challenges related to the adverse effects that occurred and the personalised treatment of the patient are also discussed. Finally, the article evaluates current advances in treatment and future therapeutic approaches. This case highlights the challenges of identifying which therapeutic options are most appropriate for individual patients with BRAFV600E metastatic melanoma. About half of all people with melanoma have a BRAFV600E gene mutation. Targeted therapies called BRAF inhibitors may be appropriate; such treatment can rapidly suppress melanoma growth and control the tumour in many patients. Immunotherapies, such as pembrolizumab, have emerged for patients with melanoma that has spread to other parts of the body. Triple combination therapy with a BRAF inhibitor, a MEK inhibitor plus pembrolizumab, can extend the therapeutic effects of BRAF/MEK inhibition, but also cause immune-related adverse events (mainly involving the gut, skin, liver, and lung). Steroids that treat these adverse events may reduce the antitumour response. This article concerns a patient who has lived with BRAFV600E-mutant melanoma for over 10 years and illustrates the situation from the perspective of both the patient and his oncologist. The patient describes how he coped with his diagnosis and treatment challenges, and his melanoma treatment pathway, including surgical interventions, medical treatment, and participation in clinical trials. He relates his experience of living with the disease and the adverse effects of treatment. The patient’s oncologist reviews the diagnostic process and explains how the therapeutic options were selected for and with the patient. The oncologist also addresses the integration of the patient into clinical trials involving programmed death-1 (PD-1) inhibitors and BRAF/MEK inhibitors. Challenges related to the adverse effects that occurred and the personalised treatment of the patient are discussed. This partnership encouraged the patient to stay on treatment, enjoy a good quality of life, care for his family, and ultimately enter complete remission.