Melanoma sucks. Mucosal melanoma sucks even more. Here are some prior posts:
Mucosal melanoma - abstracts from 2016 to now
Here is an abstract regarding the use of pembro and a case report in which a topical anti-fungal was used in a patient with vaginal melanoma (although radiation to a brain met and nivo was started as well....so it's a bit muddy!!!) to good effect. For what they're worth:
Antitumour activity of pembrolizumab in advanced mucosal melanoma: a post-hoc analysis of KEYNOTE-001, 002, 006. Hamid, Robert, Ribas, Hodi, et al.Br J Cancer. 2018 Sep 11.
Pembrolizumab provides durable antitumour activity in patients with advanced mucosal melanoma regardless of prior ipilimumab.
Itraconazole treatment of primary malignant melanoma of the vagina evaluated using positron emission tomography and tissue cDNA microarray: a case report. Inoew, Tsubamoto, Isono-Nakata, et al. BMC Cancer. 2018 Jun 4.
Primary malignant melanoma of the vagina is extremely rare, with a poorer prognosis than cutaneous malignant melanoma. Previous studies have explored the repurposing of itraconazole, a common oral anti-fungal agent, for the treatment of various cancers. Here, we describe a patient with metastatic, unresectable vaginal malignant melanoma treated with 200 mg oral itraconazole twice a day in a clinical window-of-opportunity trial.