388P - Systemic Treatment Of Metastatic Conjunctival Melanoma (388P)

Date 18 November 2017
Event ESMO Asia 2017 Congress
Session Poster lunch
Topics Cytotoxic agents
Skin cancers
Biological therapy
Presenter Simao Pinto-Torres
Citation Annals of Oncology (2017) 28 (suppl_10): x113-x116. 10.1093/annonc/mdx667
Authors S. Pinto-Torres1, T. Tomás2, E. Gouveia3, M.J. Passos3
  • 1Medical Oncology, Hospital Prof. Dr Fernando Fonseca E.P.E (Amadora/Sintra), 1170-177 - Lisbon/PT
  • 2Medical Oncology, Hospital Prof. Dr Fernando Fonseca E.P.E (Amadora/Sintra), Lisbon/PT
  • 3Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon/PT



Conjunctival melanoma (CM) is an exceptionally rare tumor, with a propensity for local and distant recurrence. Recent progress in systemic treatments, with checkpoint inhibitors and targeted therapies blocking BRAF and MEK, have redefined the standard of care of advanced unresectable and metastatic melanoma. Although most trials did not include patients with conjunctival melanoma, its close molecular and genetic relationship to cutaneous melanoma might suggest a similar response to these novel agents.


The authors describe two uncommon cases of metastatic conjunctival melanomas with distinct genetic profiles and, as such, submitted to different systemic treatments.


Case 1: A 56-year-old woman, with a CM with metastases to the right oropharyngeal wall and pharyngeal lymph nodes, with a detected BRAF V600E mutation. She initiated systemic therapy with vemurafenib in April 2014. A sustained favorable response was observed up to the present time. In February 2017, she was diagnosed with early stage invasive ductal carcinoma of the breast. She was submitted to a simple mastectomy with sentinel lymph node biopsy and began hormonal treatment. This recent diagnosis raises the question whether it can be related to a prolonged treatment with vemurafenib. Case 2: A 51-year-old man, with a remote history of human immunodeficiency virus (HIV) and hepatitis C (HCV) infections, diagnosed with a CM with metastases to the facial and cervical subcutaneous tissues and lymph nodes. No mutation in the BRAF gene was detected. Concerns were raised about the use of a checkpoint inhibitor in a patient with HIV, given the potential immune-related side effects. In December 2016, he started systemic therapy with pembrolizumab. The patient is presently on complete remission, with good tolerance to the ongoing treatment.


Both treatments seem to be valid options in the treatment of metastatic conjunctival melanoma.

Clinical trial identification

Legal entity responsible for the study

Simão Pinto Torres




All authors have declared no conflicts of interest.