# Advanced Melanoma Management: A Case Report of Pembrolizumab Use in a Haemodialysis Patient

## TL;DR

An elderly patient on dialysis with advanced melanoma successfully responded to pembrolizumab with minimal side effects over 20 months.

## Contribution

This case report provides real-world evidence of pembrolizumab's safety and efficacy in a dialysis patient with advanced melanoma.

## Key findings

- The patient showed no significant adverse events during pembrolizumab treatment.
- A durable response to pembrolizumab was observed for 20 months despite oligoprogressions.
- The case highlights the complexity of treating advanced melanoma in patients with end-stage renal disease.

## Abstract

Patients with end-stage renal disease are a challenge for oncologists. Despite the recognised benefit in the overall survival of pembrolizumab in patients with advanced melanoma, data on its safety and efficacy in dialysis patients are scarce. We present a clinical case of an 87-year-old woman on haemodialysis with advanced melanoma treated in the first line with pembrolizumab 200 mg every three weeks. She shows no significant adverse events and a good response to treatment. Although she underwent surgical treatment for two oligoprogressions, the patient maintained treatment with pembrolizumab, now demonstrating a response duration of 20 months. The age and comorbidities in this case, coupled with the lack of robust scientific evidence on the use of immunotherapy in dialysis patients, illustrate the daily complexity of therapeutic decisions in oncology.