Encorafenib+Binimetinib (BRAF/MEK) Produces Rapid LMD Response and ~14-mo Survival (Case)

Encorafenib (BRAF inhibitor) plus binimetinib (MEK inhibitor) were re-introduced at reduced doses in a 69-year-old man with BRAF V600K metastatic melanoma who developed leptomeningeal disease (LMD) and had declined immunotherapy (n=1; case report; NCT05026983). MRI showed edema reduction within days and radiologic response over months; survival was ~14 months from LMD diagnosis. There is no established SOC for melanoma LMD—guidelines emphasize multimodal and investigational care—with historical median OS ≈2–6 weeks to months; recent prospective LMD cohorts report mOS 2.9 months with IV ipilimumab+nivolumab and 4.9 months with concurrent IT+IV nivolumab, so this single-patient course is longer than typical benchmarks; toxicity details for the rechallenge were not fully described.