Jason Luke, MD: Predicting Which Patients Will Experience Durable Responses to Targeted Therapy

What can be done to help predict which patients might experience durable responses to targeted therapy, like Sarah's?

Factors that might predict the benefit over a long period of time for targeted therapy are currently under development. The research space, what we have available now really, are clinical factors such as age—younger being more likely to respond and do better over time—low LDH, sites of disease being less than three and not liver metastases as well as not brain metastases obviously. Those are really the predictors that we have to try to identify patients right now.

CASE: Metastatic Melanoma

Sarah is a 50-year-old Caucasian postal worker who presented to her primary care physician with multiple, skin-colored nodules and palpable lymph nodes. .

• A workup, biopsy, and mutation test was conducted, which revealed BRAF V600E mutation-positive melanoma that had metastasized to the lymph nodes, subcutaneous tissue, and right adrenal gland.    
• ECOG performance status is 0 and her LDH levels are normal.

The patient was started on the combination of dabrafenib and trametinib. She experienced a durable complete response and has remained on therapy for 36 months.