European Interbalkan Medical Center, 10 Asklipiou Street, 55535 Pylaia, Greece
Konstantina Papadopoulou
1st Department of Internal Medicine, G. Papanikolaou General Hospital of Thessaloniki, 57010 Thessaloniki, Greece
Chrysi Maria Mystakidou
Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
Evanthia Papadopoulou
Shakolas Educational Centre for Clinical Medicine, University of Cyprus, Old Road Nicosia-Lemesos 215/6, 2029 Nicosia, Cyprus
Stylianos Mantalovas
3rd Surgical Department, “AHEPA” University Hospital of Thessaloniki, School of Medicine, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
Nikolaos Varsamis
European Interbalkan Medical Center, 10 Asklipiou Street, 55535 Pylaia, Greece
Charilaos Koulouris
European Interbalkan Medical Center, 10 Asklipiou Street, 55535 Pylaia, Greece
Vasiliki Theodorou
Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
Konstantinos Papadopoulos
3rd Surgical Department, “AHEPA” University Hospital of Thessaloniki, School of Medicine, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
Christina Sevva
3rd Surgical Department, “AHEPA” University Hospital of Thessaloniki, School of Medicine, Aristotle University of Thessaloniki, 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece
Petrina Miltiadous
Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
Savvas Petanidis
Laboratory of Medical Biology and Genetics, Department of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
Eleni Georgakoudi
European Interbalkan Medical Center, 10 Asklipiou Street, 55535 Pylaia, Greece
Eleni Papadopoulou
European Interbalkan Medical Center, 10 Asklipiou Street, 55535 Pylaia, Greece
Sofia Baka
European Interbalkan Medical Center, 10 Asklipiou Street, 55535 Pylaia, Greece
Melanoma is the most aggressive type of skin cancer. Half of melanoma cases are characterized by the mutation BRAF V600. The case presented concerns a 41-year-old patient with locally advanced melanoma, being positive in mutation BRAF V600. The patient underwent surgery and received additional targeted therapy as part of a clinical study. In subsequent disease progression, immunotherapy was used. When the disease progressed again while the patient was in a good performance status, targeted therapy was administered again, and a good response was noted, making the patient reach a statistically significant overall survival, exceeding four years. Targeted therapy has proven to be an important tool in the treatment of melanoma. The use of BRAFi targeted therapy does not exclude the option of readministration at subsequent disease progression (BRAFi rechallenge). Preclinical models suggest that the resistance mechanism of cancer cells to BRAFi therapy bends, as these cell clones lose their evolutionary advantage after stopping BRAFi. Cell clones sensitive to BRAFi may then outcompete, making the treatment effective again. Therapeutical dilemmas in the management of patients with locally advanced melanoma that progresses to metastatic cancer are discussed.
