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Imafuku K, Yoshino K, Yamaguchi K, et al. Sudden Onset of Brain Metastasis despite the Use of Vemurafenib for Another Metastatic Lesion in Malignant Melanoma Patients. Case Rep Oncol. 2017;10(1):290-295doi: 10.1159/000461576.
Imafuku, K., Yoshino, K., Yamaguchi, K., Tsuboi, S., Ohara, K., & Hata, H. (2017). Sudden Onset of Brain Metastasis despite the Use of Vemurafenib for Another Metastatic Lesion in Malignant Melanoma Patients. Case reports in oncology, 10(1), 290-295. https://doi.org/10.1159/000461576
Imafuku, Keisuke, et al. "Sudden Onset of Brain Metastasis despite the Use of Vemurafenib for Another Metastatic Lesion in Malignant Melanoma Patients." Case reports in oncology vol. 10,1 (2017): 290-295. doi: https://doi.org/10.1159/000461576
Imafuku K, Yoshino K, Yamaguchi K, Tsuboi S, Ohara K, Hata H. Sudden Onset of Brain Metastasis despite the Use of Vemurafenib for Another Metastatic Lesion in Malignant Melanoma Patients. Case Rep Oncol. 2017 Apr 04;10(1):290-295. doi: 10.1159/000461576. eCollection 2017. PMID: 28512412; PMCID: PMC5422723.
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Case Rep Oncol. 2017 Apr 04;10(1):290-295. doi: 10.1159/000461576. eCollection 2017.

Sudden Onset of Brain Metastasis despite the Use of Vemurafenib for Another Metastatic Lesion in Malignant Melanoma Patients.

Case reports in oncology

Keisuke Imafuku, Koji Yoshino, Kei Yamaguchi, Satoshi Tsuboi, Kuniaki Ohara, Hiroo Hata

Affiliations

  1. aTokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
  2. bDepartment of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

PMID: 28512412 PMCID: PMC5422723 DOI: 10.1159/000461576

Abstract

Vemurafenib is an inhibitor of the BRAF mutation and has been approved by the Food and Drug Administration as a treatment option for patients with unresectable melanoma without brain metastasis. In the literature, vemurafenib has been reported to be also effective against brain metastasis. We encountered 3 cases with brain metastasis on vemurafenib therapy. In these cases, vemurafenib was clinically effective against metastatic lesions other than those in the brain. The brain lesions developed after the metastatic lesion had occurred. Therefore, we assume that the melanomas of the patients acquired resistance against vemurafenib. The brain metastases were treated with the cyberknife. Patients 1 and 2 without LDH elevation are still alive, but patient 3 with abnormal LDH elevation died despite the treatment. We need to carefully follow patients on vemurafenib therapy because brain metastasis can suddenly occur even if the metastatic lesion has decreased clinically. The therapeutic effect of vemurafenib against brain metastasis is poor in cases with LDH elevation.

Keywords: BRAF mutation; Brain metastasis; Drug resistance; Heterogeneous lesion; LDH; Malignant melanoma; Vemurafenib

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