Inmunoterapia como tratamiento de un melanoma metastásico. Reporte de caso

Abstract

Introduction: Melanoma is a type of cancer that affects melanocytes. Its worldwide incidence is 324,365, with a total of 139 reported cases of melanoma-related deaths in Ecuador. It is more prevalent in males and individuals of white race. Melanoma can affect any part of the body, including the eyes or mucous membranes. Diagnosis is typically performed through a biopsy, which is considered the gold standard, although there are other tests available. We present the case of a 51-year-old patient who presents with a fungating, exophytic, and bleeding dermal lesion on the left upper limb, which has been progressively growing for 2 months and has spread to the lungs with multiple lesions. An incisional biopsy was performed, reporting: non-mutated BRAF, Melan A with mixed inflammatory infiltrate, classifying it as Metastatic Stage IV Melanoma. Currently, the patient is undergoing immunotherapy treatment with pembrolizumab every 21 days, showing adequate tolerance, no signs of toxicity, and undergoing extension exams every 6 months. Additionally, there is endocrinology follow-up due to a thyroid nodule.

Methodology: This study is a descriptive case report with a non-experimental documentary approach. We collected articles, meta-analyses, and reported cases related to the proposed topic from the last 5 years. The search was conducted using databases such as Scopus, Proquest, The Lancet, PubMed, among others.

Conclusion: The diagnosis of melanoma is made through a biopsy, and the treatment can be determined based on the disease staging. Targeted therapy with pembrolizumab has proven to be effective in treating metastatic melanoma, improving the patient's clinical condition, life prognosis, with fewer side effects, and low toxicity.