Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):695-697 | DOI: 10.5507/bp.2015.061

Rapid and clinically significant response to masitinib in the treatment of mucosal primary esophageal melanoma with somatic KIT exon 11 mutation involving brain metastases: A case report

Jarmila Prosvicova^a, Sarka Lukesova^a,b, Jindrich Kopecky^c, Jiri Grim^c, Zdenek Papik^d, Renata Kolarova^d, Blanka Navratilova^e, Patrice Dubreuil^f,g, Julie Agopian^g, Colin Mansfield^g, Alan Moussy^g, Olivier Hermine^g,h

^a Department of Clinical Oncology, County Hospital, Nachod, Czech Republic

^b Department of Clinical Microbiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Hradec Kralove

^c Department of Clinical Oncology and Radiotherapy, University Hospital in Hradec Kralove

^d Endoscopic Centre, County Hospital, Nachod

^e Department of Histopathology, County Hospital Nachod

^f Inserm, U1068, CRCM (Signaling, Hematopoiesis and Mechanism of Oncogenesis); Institut Paoli-Calmettes, Aix-Marseille Univ, F-13284; CNRS, UMR7258, Marseille, F-13009, France

^g AB Science, Paris, France

^h Hospital Necker, Paris; CNRS UMR 8147, Department of Hematology, Universite Paris V Rene Descartes, Paris; Institut Imagine, Universite Sorbonne Paris cite, Paris, France

Background: Malignant melanoma in the gastrointestinal tract may be primary or metastatic. Mucosal melanoma is a quite rare and aggressive disease, growing hidden and diagnosed with a certain delay which makes treatment difficult.

Case Report: The authors present the first patient with c-kit exon 11 mutated primary esophageal melanoma treated with oral tyrosine kinase inhibitor masitinib. A 55-year-old-man presented with esophageal melanoma metastising into visceral organs and to the brain. The patient showed objective and clinical significant therapeutic response to masitinib. After initiation of masitinib, dysphagia and odynophagia disappeared within 1 week. Following 1 month of treatment, computed tomography showed a regression in the number and size of brain metastatic lesions and regression in visceral lesions. This therapeutic response, despite the aggressive disease on treatment initiation, effectively enabled the patient to have 6 months of quality life.

Conclusion: This report corroborates the plausibility of treating advanced melanoma carrying a mutation of KIT with masitinib. It also raises the question of masitinib treatment beyond progression. Additionally, the observed masitinib treatment effect on the brain suggests accumulation of therapeutically relevant concentration of masitinib in the central nervous system. This observation has possible ramifications for treatment of intracranial neoplasms.

Keywords: esophageal melanoma, masitinib, targeted therapy

Received: October 12, 2015; Accepted: November 24, 2015; Prepublished online: November 27, 2015; Published: December 3, 2015  Show citation