COMPLETE RESPONSE OF CUTANEOUS METASTASIS IN A MELANOMA PATIENT TREATED WITH IPILIMUMAB. Francesco Spagnolo, Serena Savaia, Marco Grosso, Paola Queirolo Introduction We present the case of a 58 year old, woman, who achieved complete response for her cutaneous melanoma metastasis after treatment with ipilimumab at 3 mg/Kg. In March 2008 the patient underwent a lesion excision from the skin of her right leg, which was diagnosed as a 1.71 mm thick non ulcerated malignant melanoma,,presenting 1-6 mito- sis per HPF (pT2a according to the 2009 AJCC melanoma staging and classification). In addition to the wide excision, three sentinel lymph nodes were excised. Since one of them was positive for micrometastasis, an inguinocruroiliac dissection was performed: of 16 lymph nodes, none carried melanoma metastasis (pN1a). A CT-scan was negative for distant metastasis (M0). In October 2008, the patient showed several lesions on the right leg, clinically consistent with melanoma metastasis: a biopsy confirmed their histology. The patient was not eligi- ble for hyperthermic antiblastic perfusion with tumor necrosis factor alpha and Melpha- lan, so she started therapy with low-dose interferon-alpha. Since no response was achieved with interferon alpha, in February 2009 the patient started chemotherapy with dacarbazin 800 mg/m 2 every 3 weeks. A partial response of the cutaneous metastasis was noted after 4 cycles, so treatment with dacarbazin was continued. In the meanwhile, the patient was monitored with PET/CTs, CT-scans and abdomen-US, confirming the absence of other metastasis. After 26 cycles of dacarbazin, the cutaneous lesions pro- gressed, so a second line treatment with ipilimumab was chosen. The patient was eligi- Case Report © EUROMEDITERRANEAN BIOMEDICAL JOURNAL 2012, 7(2):3 – 6 . DOI: 10.3269/1970-5492.2012.7.2 Available on-line at: http://www.embj.org SUMMARY We present the case of a 58 year old woman, who achieved complete response for her cu- taneous melanoma metastasis after treatment with ipilimumab at 3 mg/Kg. The patient was given dacarbazine as a first line treatment for her cutaneous metastasis and a partial response was achieved. However, after 26 cycles of chemotherapy, the cutaneous lesions progressed, so ipilimumab was chosen as a second line treatment. The patient was eligi- ble for the compassionate use of ipilimumab.Two weeks after the fourth cycle with ipilimumab, a complete response of most cutaneous metastasis was noted, with a partial response of the remaining lesions, which were still regressing at the last follow-up visit. Ipilimumab, which was recently reported to improve survival in patients with metastatic melanoma, represents a most promising immunotherapeutic drug and it has been ap- proved for patients with advanced melanoma as a first- and second-line treatment by the FDA and as a second-line treatment by the European Medicines Agency (EMA). Address of the authors S.C. Oncologia Medica A - Melanoma and Biotherapy Unit Istituto Nazionale per la Ricerca sul Can- cro; Genoa – Italy Send correspondence to: Dr. Marco Grosso, marcobig@fastwebnet.it Received: January 10th, 2012 — Revised: January 17th, 2012 — Accepted: January 23rd, 2012 ISSN 2279-7165 - Euromediterranean Biomedical Journal [online]