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V600E mutant melanoma. The surgical cavity and remaining metastasis were treated with stereotactic radiosurgery (SRS), followed by four cycles of ipilimumab, a CTLA-4 inhibitor. In December 2015, CNS progression was noted with interval development of seven brain metastases, which were treated with SRS. Extracranial disease assessment showed progression with an increase in lymphadenopathy and metastasis to the adrenal gland. He was started on pembrolizumab, an anti-PD1 inhibitor. In February 2016, imaging showed mild progression of the adrenal metastasis but significant increase in the supraclavicular adenopathy, which required palliative radiotherapy (2000 cGy in five fractions). Two months after the last dose of pembrolizumab, complete resolution of the extra-CNS disease was documented, but development of enhancing nodules along the left lateral ventricle wall was noted intracranially (Fig. 1a). Lumbar puncture was performed, and cytologic evaluation of the cerebrospinal fluid (CSF) confirmed LMD. Systemic therapy was initiated with dabrafenib (BRAF inhibitor) in combination with trametinib (MEK inhibitor). Within a week, the patient’s neurological symptoms improved, and 3 weeks after the initiation of combination targeted therapy, resolution of LMD was noted on imaging (Fig. 1b). Repeat brain MRI 6, 12, 24 and 36 weeks later confirmed ongoing treatment response, and no evidence of extracranial disease. Our case illustrates that combination therapy with BRAF and MEK inhibitors can lead not only to a rapid resolution of neurological symptoms, but also radiologic resolution of LMD in MM patients. To our knowledge, this is the first report of a MM patient demonstrating a prolonged and sustained progression free survival (PFS) of >11 months to date with this combination regimen alone, i.e. without any additional radiotherapy. Geukes Foppen et al. have previously described an extended To the Editor,