Topics:
Radiation Oncology • Melanoma/Skin Cancer
How would you approach the treatment of a patient with a history of cutaneous melanoma and only overt site of disease being a bulky level III axillary lymph node?
Specifically, this patient was unable to tolerate immunotherapy due to severe side effects.
Answer from: Radiation Oncologist at Academic Institution
Surgery and postop RT.
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Answer from: Radiation Oncologist at Academic Institution
Therapeutic lymphadenectomy with or without adjuvant radiation therapy. There may be a role for targeted therapy depending on the mutation profile of the tumor.
Answer from: Radiation Oncologist at Community Practice
The bulky local problem is only the tip of the iceberg. I would test for BRAF mutation. I would consider first neoadjuvant therapy with NIVO/IPI or if BRAF mutated, there are three possible combination of drugs to use if patient has had prior exposure to IO. If there is a good response to neoadjuvan...