Multiple epidermotropic melanoma metastases developing during BRAF and MEK inhibitor therapy

Since introduction of BRAF and MEK inhibition therapy, there has been a significant improvement in response rates, overall survival, and progression-free disease in melanoma patients.1-3 Combined BRAF and MEK inhibition, compared with BRAF inhibition alone, has shown to delay the emergence of resistance in patients suffering from BRAF V600–mutated advanced melanoma. It has become the standard of care in patients carrying this mutation.4 Several mechanisms of resistance to BRAF and MEK inhibition have been shown.