Case report: Concurrent intrathecal and intravenous pembrolizumab for metastatic melanoma with leptomeningeal disease

Xiang Dan; Mengxi Huang; Zhaochen Sun; Xiaoyuan Chu; Xin Shi; Yitian Chen

doi:10.3389/fonc.2024.1344829

Case report: Concurrent intrathecal and intravenous pembrolizumab for metastatic melanoma with leptomeningeal disease

Front Oncol. 2024 Apr 11:14:1344829. doi: 10.3389/fonc.2024.1344829. eCollection 2024.

Authors

Xiang Dan¹, Mengxi Huang², Zhaochen Sun^{1

2}, Xiaoyuan Chu³, Xin Shi⁴, Yitian Chen²

Affiliations

¹ Affiliated Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.
² Department of Medical Oncology, Affiliated Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.
³ Department of Radiation Oncology, Affiliated Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.
⁴ Department of Orthopedics, Jinling Hospital, Nanjing, China.

Abstract

Leptomeningeal disease (LMD) is a serious cancer complication associated with poor prognosis. Approximately 5%-25% of patients with melanoma develop LMD. Currently, no standard treatment protocol exists and very few cases have been reported. Despite ongoing advances in new therapies, treatment options for LMD remain limited. Herein, we report a case of intrathecal pembrolizumab administration in a patient with melanoma and LMD. Intrathecal pembrolizumab administration was feasible and safe at the doses tested. Drawing from this case, along with our expertise and the existing evidence on systemic immunotherapy, we propose that an immunotherapy approach involving intrathecal administration for patients with LMD from melanoma warrants additional exploration in clinical trials.

Keywords: cancer; immunotherapy; leptomeningeal disease; metastatic melanoma; pembrolizumab.

Publication types

Case Reports

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Natural Science Foundation of China [81972332 to YC, 82002583 to MH].