Complete Stage 3 Melanoma Regression with Combination Encorafenib and Binimetinib Treatment – A Case Report and Literature Review

The global incidence of melanoma is increasing at an annual growth rate of 5%. There are significant survival rate disparities, with paediatric patients having a 17% 5-year survival rate, compared to a 5% 10-year survival rate among the adult population. In Ireland, melanoma is the fourth most prevalent cancer, with 1100-1200 new cases annually. Globally, it is the sixth most frequently occurring cancer, accounting for 4% of new cancer diagnoses and 1.3% of cancer deaths in the EU-27 in 2020. Management of head-and-neck melanoma is complex and requires a multidisciplinary approach. The primary treatment is surgical excision with safety margins of 1-2 cm, and sentinel lymph node biopsy (SLNB) is recommended for staging. Adjuvant therapies include anti-PD-1 treatments and BRAF/MEK inhibitors. In this paper, we highlight the case of a 44-year-old female with stage 3 melanoma which demonstrates the potential of neoadjuvant immunotherapy with encorafenib and binimetinib. This treatment resulted in significant tumor regression, and allowed for subsequent surgical excision while preserving facial nerve function. Furthermore, postoperative outcomes showed complete regression of melanoma. This case highlights the efficacy of neoadjuvant immunotherapy in achieving significant tumor reduction, facilitating less invasive surgery, and preserving critical anatomical structures.