, Volume 259, Issue 9, pp 1976-1978
Date: 18 Apr 2012

Clinical and radiological response of leptomeningeal melanoma after whole brain radiotherapy and ipilimumab

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Dear Editors,

Until recently, dacarbazine (DTIC) was the only registered chemotherapeutic drug for systemic treatment of metastatic melanoma. Patients with progressive disease during DTIC treatment can now also be treated with ipilimumab, a human monoclonal antibody directed against the cytotoxic T-lymphocyte antigen-4 (CTLA-4) receptor. Binding of ipilimumab to the CTLA-4 receptor enhances the immune response of T-lymphocytes, resulting in an offensive against the tumor and an increased median survival of patients with metastatic melanoma [1]. Few data are available on the effect of ipilimumab on central nervous system (CNS) metastases of melanoma [2, 3]. Here, we report a patient with stage IV melanoma, who showed a remarkable response of leptomeningeal metastases (LM) after whole brain radiotherapy (WBRT) and ipilimumab treatment.

In January 2009, a 63-year-old woman was diagnosed with lung metastases of a melanoma. DTIC (800 mg/m2, q3 weeks) was initiated. In May 2010, after 17 cours