Potential utilization of neopterin measurements in the assessment of pyrexia in metastatic melanoma treated with combined targeted therapy: a case report

Marie Bartoušková,Kateřina Kučerová,Pavla Petrová,Bohuslav Melichar,Michaela Hrouzková,Hana Študentová,Filip Čtvrtlík,Nikol Rušarová,Andrea Vernerová

doi:10.1515/pteridines-2020-0009

Marie Bartoušková, Kateřina Kučerová + Show 7 more

Open Access

https://doi.org/10.1515/pteridines-2020-0009

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Abstract

Abstract In patients with metastatic melanoma the advent of targeted therapy and immune checkpoint inhibitors has transformed the management of advanced and metastatic disease, resulting in improved outcomes. Neopterin is a biomarker of immune activation increased in cancer as well as in other conditions associated with immune activation. We present a case of a patient with advanced metastatic melanoma responding to the combination targeted therapy with dabrafenib and trametinib. The treatment was complicated by a fever that was accompanied by a marked rise in serum and urinary neopterin concentrations. Present case report illustrates not only the efficacy of combined targeted therapy, but also the utilization of neopterin measurements in the diagnosis and monitoring of pyrexia in patients with metastatic malignant melanoma.

Highlights

In patients with metastatic melanoma the advent of targeted therapy and immune checkpoint inhibitors has transformed the management of advanced and metastatic disease, resulting in improved outcomes
We present here a case of a patient with remarkable response to the combination of dabrafenib and trametinib accompanied by marked changes in serum and urinary neopterin concentrations that reflected the course of the disease and therapy, in particular the fever induced by the treatment
The present case report demonstrating the efficacy of combined targeted therapy in a patient with BRAF-mutated melanoma illustrates the potential role of repeated neopterin measurements in the supportive care, including the diagnosis and monitoring of side effects of targeted therapy

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Open Access

Marie Bartoušková, Michaela Hrouzková, Filip Čtvrtlík, Pavla Petrová, Nikol Rušarová, Kateřina Kučerová, Andrea Vernerová, Bohuslav Melichar, Hana Študentová* Potential utilization of neopterin measurements in the assessment of pyrexia in metastatic melanoma treated with combined targeted therapy: a case report https://doi.org/10.1515/pteridines-2020-0009 received April 13, 2020; accepted July 16, 2020.

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