Archive for August, 2008

Thoracic Melanoma Metastasis Becomes Resectable After Investigational Therapy

August 21, 2008

A patient at CORT presented with isolated right hilar metastasis of melanoma.  The patient’s original truncal melanoma was removed completely from the right posterior thorax in 2001.  After his recurrence in the right hilum, he had received high-dose IL-2, with progression.  His staging studies included PET/CT demonstrating intense uptake in the hilar mass, but no other metastases.  Brain MRI scan and conventional CT scans were also negative, except for the hilar mass. The disease was not felt to be resectable because of the large size and proximity to the hilar structures.  

The patient received an investigational treatment at CORT from 1/2/08 through 7/9/08.  His disease in the right hilum decreased from 3 cm to 12-15 mm, and the regression was enough for surgical intervention to be reconsidered.  Re-staging prior to surgery continued to show no other metastatic disease.  The PET SUV of the hilar mass had substantially decreased, to 1.8 at follow-up.

The patient had thoracic exploration and surgical excision of the hilar disease in early 8/08.  He had a necrotic, regional with inflammatory cells but no tumor.  An area adjacent to this contained a node measuring 1.2 cm, which contained residual viable metastatic melanoma. The disease was completely resected, and the patient had an uneventful postoperative course and was discharged from the hospital after 3 days. 

The investigational drug in this case cannot be mentioned in this time, because of confidentiality of the ongoing study.   However, this case is an illustration of the importance of ongoing research efforts in melanoma therapy.  Patients with this disease have limited treatment options, and new therapies may hold substantial promise for improving survival.