Immunotherapy Achieves Complete Remission in Pregnant Patient with Stage IV Melanoma Brain Metastasis
核心洞察
A 38-year-old pregnant woman's headaches and nausea, initially dismissed as pregnancy symptoms, were found to be caused by a giant brain tumor from metastatic stage IV melanoma (搜索).
After delivering her baby via C-section at 34 weeks, the patient underwent a second brain surgery that successfully removed the entire regrown tumor.
Immunotherapy (搜索) initiated in June 2020 produced "pretty remarkable" results, with the patient declared to have no evidence of disease by October 2020.
A routine family vacation in February 2020 became the starting point of an extraordinary medical journey for Jenney Bitner, then a 38-year-old mother of three who was 22 weeks pregnant with her fourth child. What two urgent care clinics dismissed as pregnancy-related symptoms — severe headaches, nausea, vomiting, and balance problems — turned out to be a giant brain tumor caused by stage IV melanoma (搜索) that had metastasized to her brain. The case highlights both the diagnostic challenges of cancer during pregnancy and the transformative potential of modern immunotherapy (搜索).
A Diagnosis Delayed
Bitner's symptoms began while visiting family in San Diego. After being told at two urgent care facilities that her condition was likely pregnancy-related, she returned home to Washington state, where her condition deteriorated further. She fell twice, prompting her husband to take her to the emergency room. An MRI revealed what doctors described as a giant tumor in her brain. Subsequent testing confirmed the mass was metastatic melanoma (搜索) — a diagnosis that came as a complete shock, as Bitner had never noticed an abnormal mole or skin lesion.
"I had just turned 38, and I was pregnant with my fourth kid. I was thinking, 'I'm too young for this to be happening,'" Bitner recalled. "I was thinking, 'There's no way I'm going to make it through this. I'm never going to see this baby survive to a year old.' I was terrified."
According to the American Cancer Society, patients with stage IV melanoma (搜索) that has spread to distant sites face a five-year survival rate of approximately 35%.
Navigating Cancer Treatment During Pregnancy
Bitner's clinical team faced a complex treatment dilemma. The first brain surgery removed most of the tumor, but her neurosurgeon could not extract the entire mass without risking permanent brain damage. Further testing also identified a cancerous nodule in Bitner's back — one so large it could be felt through her skin.
Immunotherapy (搜索) was identified as the optimal treatment strategy, but it posed significant risks to the unborn child. After several weeks of close monitoring, doctors determined that delivery via C-section at 34 weeks was necessary before treatment could commence.
Days before the scheduled delivery, Bitner again experienced nausea and headaches. A scan revealed devastating news: the brain tumor had regrown to its full size in just weeks. She would require a second brain surgery in addition to immunotherapy (搜索).
"I had these three and a half children, and my thought was, 'I'm not going to see them grow up,'" Bitner said. "I started writing them letters, like, all these things that I was going to want to say to them, because I didn't think I'd be there to say it to them."
On May 4, 2020, Bitner delivered her son via C-section. They named him Marcus, after her neurosurgeon. He weighed 3 pounds, 12 ounces and required neonatal intensive care, but was described by Bitner's husband as "a fighter" who was "feisty already."
Surgical Success and Immunotherapy (搜索) Response
One week after delivery, Bitner underwent her second brain surgery. This time, the surgeon was able to remove the entire tumor. After another week of recovery, both mother and son were discharged from the hospital on the same day — a moment Bitner's husband described as "joyous."
In early June 2020, Bitner began immunotherapy (搜索). The treatment aimed to boost her immune system so her white blood cells could attack cancerous cells throughout her body and brain. Tests had previously shown new areas of concern near her lung, thigh, and brain, heightening anxiety about treatment outcomes.
The response was rapid and dramatic. Within days, Bitner's husband noted that the cancerous spot on her back could no longer be felt. Soon, other lumps on her skin shrank. Scans confirmed what Bitner described as "pretty remarkable" progress. By her final immunotherapy (搜索) session, she felt well enough to drive herself to the appointment.
The treatment course was not without complications. Bitner experienced rare side effects, including an allergic reaction and a bout of encephalitis, both of which required hospitalization. Yet by October 2020, her oncologist delivered the news she had feared she would never hear: she had no evidence of disease.
A "Phase Shift" in Cancer Care
Dr. Alicia Zhou, CEO of the Cancer Research Institute, a nonprofit that supports immunotherapy (搜索) research, contextualized Bitner's outcome within the broader transformation of oncology. "Before immunooncology, we weren't really able to say the word 'cure' for these patients who were suffering from Stage IV metastatic disease, and now we can," Zhou said. "It's really, truly transformational for these patients."
Nearly six years after her diagnosis, Bitner remains cancer-free and is focused on raising awareness for immunotherapy (搜索) research while embracing family life. "I feel like every day I've had since all this has happened has been a gift. I shouldn't have had all this time, and so I take every day as something precious," she said. "It's chaos in my house all the time. And there was a time I would have dreaded it ... but now those are sounds I didn't think I was going to get to hear, so they're music to my ears."