Patient with stage IV melanoma with BRAF mutation - immunotherapy or BRAF and MEK inhibitors?

Treatment of patients with non-operative or metastatic melanoma has changed. New therapies (immunotherapy, targeted therapies - BRAF/MEK inhibitors) significantly prolonged the survival of melanoma patients. The therapy sequence has not been determined, especially in the group of patients with BRAF mutation-positive melanoma. We present a case of a 44-year-old patient with BRAF mutation-positive metastatic. Due to the slow current course of the disease, normal LDH activity, lack of metastases to the central nervous system, it was decided to use nivolumab immunotherapy in the first line of treatment. After 24 weeks of treatment, a partial remission was observed. The treatment was without complications. Currently, the patient continues immunotherapy. Treatment with nivolumab in the described case proved to be effective. The decision about the choice of a particular procedure must be consistent with dynamic of cancer, the patient's current condition and should always be discussed with the patient.