Partial response of metastatic melanoma to BRAF-inhibitor-monotherapy in a pregnant patient with no fetal toxicity

Marcé, Diane; Cornillier, Hélène; Denis, Christelle; Jonville-Béra, Annie Pierre; Machet, L.

doi:10.1097/cmr.0000000000000600

Cited by 10 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For patients with advanced disease, there are few conclusive data to support the use of either immunotherapy or BRAF-directed treatments during pregnancy due to the possibility of teratogenic and embryotoxic effects [6]. A few case reports have been published and consist of patients who wished to continue their pregnancy, or who became pregnant while on treatment [8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Adrenal metastatic melanoma first identified during pregnancy: a diagnostic challenge

et al. 2022

View full text Add to dashboard Cite

Adrenal nonadenomatous tumors (NAT) first identified during pregnancy are very rare and pose a diagnostic and therapeutic dilemma with significant risks for the mother and fetus. The aim of this study is to report a case of a large adrenal NAT identified in pregnancy and literature review. A literature search was conducted, and data were summarized. A 37-year-old primigravida woman, with a history of melanoma, excised 12 years before presentation without recurrence, presented at 35 weeks gestation due to intractable right flank pain. MRI demonstrated an eight cm, heterogeneous, septate, right adrenal mass suspected to be either pheochromocytoma/paraganglioma (PPGL), adrenocortical carcinoma or metastasis. Blood metanephrines were sent urgently to enable a safe delivery and were within normal range, as were cortisol and androgen levels. A biopsy was taken from a palpable breast mass as well as from an ovarian mass during the operation. At 36 weeks gestation, she was delivered by cesarean section. PET computed tomography performed after delivery revealed the extensive metastatic spread of recurring melanoma including the right adrenal gland. Timely diagnosis and management by a multidisciplinary team are important to avoid a catastrophic outcome. There is no consensus on optimal management and timing of delivery. PPGL should be ruled out before delivery.

show abstract

Section: Discussionmentioning

confidence: 99%

Adrenal metastatic melanoma first identified during pregnancy: a diagnostic challenge

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Even though new interventions like targeted- and immunotherapies improved OS and progression-free survival (PFS), these therapies involve the risk of severe adverse events and are therefore often contraindicated during pregnancy [ 42 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

MUG Mel3 Cell Lines Reflect Heterogeneity in Melanoma and Represent a Robust Model for Melanoma in Pregnancy

Schrom

Hebesberger

Wallner

et al. 2021

IJMS

View full text Add to dashboard Cite

Melanomas are aggressive tumors with a high metastatic potential and an increasing incidence rate. They are known for their heterogeneity and propensity to easily develop therapy-resistance. Nowadays they are one of the most common cancers diagnosed during pregnancy. Due to the difficulty in balancing maternal needs and foetal safety, melanoma is challenging to treat. The aim of this study was to provide a potential model system for the study of melanoma in pregnancy and to illustrate melanoma heterogeneity. For this purpose, a pigmented and a non-pigmented section of a lymph node metastasis from a pregnant patient were cultured under different conditions and characterized in detail. All four culture conditions exhibited different phenotypic, genotypic as well as tumorigenic properties, and resulted in four newly established melanoma cell lines. To address treatment issues, especially in pregnant patients, the effect of synthetic human lactoferricin-derived peptides was tested successfully. These new BRAF-mutated MUG Mel3 cell lines represent a valuable model in melanoma heterogeneity and melanoma pregnancy research. Furthermore, treatment with anti-tumor peptides offers an alternative to conventionally used therapeutic options—especially during pregnancy.

show abstract

“…New therapies for MM, such as immunotherapy and targeted therapy, have improved OS and progression-free survival, but their use is often contraindicated in pregnant patients due to the potential for serious adverse reactions 65,66 . The immunotherapy ipilimumab acts on the CTLA4 pathway, whereas pembrolizumab and nivolumab act on the PD-1 pathway 67 .…”

Section: Methodsmentioning

confidence: 99%

Melanoma During Pregnancy as a Complicated Medical Problem

Kościelecka¹,

Kubik-Machura²,

Kuć³

et al. 2023

Obstetrical &Amp; Gynecological Survey

View full text Add to dashboard Cite

ImportancePregnancy-associated melanomas (PAMs)—this is how melanomas identified during the childbearing years or up to 1 year after birth have been defined, accounting for one third of women in whom it is diagnosed. The exact epidemiology of melanoma is difficult to determine. However, its incidence is undoubtedly increasing, most likely related to the increasing age of mothers.ObjectiveThe purpose of this study was to review the prognosis, diagnosis, and treatment; the effect of melanoma on pregnancy; and the effect of pregnancy on melanoma and melanocytic lesions.Evidence AcquisitionAn extensive manual search of major electronic databases was conducted in January 2022. The following literature review provides comprehensive coverage of PAMs.ResultsAny new nevus detected during pregnancy and changes in the nevus regarding color, diameter, symmetry, or lesion border require medical evaluation. New therapies for malignant melanoma, such as immunotherapy and targeted therapy, have improved overall survival and progression-free survival, but their use is often contraindicated in pregnant patients. Melanoma is considered to be the neoplasm most commonly involving the fetus and placenta.ConclusionsThere are reports where immunotherapy and targeted therapy used in the patient were not associated with serious consequences for the fetus, being a therapeutic option for the patient. The described cases of pregnancy outcome during modern melanoma treatment are extremely important and may allow to shape the optimal therapeutic regimen in pregnant women with melanoma.RelevanceEducation of pregnant women in the context of observation of skin lesions as well as maintenance of oncological vigilance by physicians seem to be an important element in limiting difficult decisions related to therapy of more advanced disease. Further large-scale studies using modern treatment in pregnant women with melanoma are needed.Target AudienceObstetricians and gynecologists, family physicians.Learning ObjectivesAfter completing this activity, the learner should be better able to describe the importance of oncologic vigilance in the context of developing melanoma in a pregnant woman; discuss the need for further research on the use of immunotherapy and targeted therapy in pregnant women with melanoma; and explain the need for oncologic vigilance in the context of melanoma in children of mothers who developed melanoma during pregnancy.

show abstract

Partial response of metastatic melanoma to BRAF-inhibitor-monotherapy in a pregnant patient with no fetal toxicity

Cited by 10 publications

References 5 publications

Adrenal metastatic melanoma first identified during pregnancy: a diagnostic challenge

Adrenal metastatic melanoma first identified during pregnancy: a diagnostic challenge

MUG Mel3 Cell Lines Reflect Heterogeneity in Melanoma and Represent a Robust Model for Melanoma in Pregnancy

Melanoma During Pregnancy as a Complicated Medical Problem

Contact Info

Product

Resources

About