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Immunotherapy. 2019 Jan 4. doi: 10.2217/imt-2018-0149. [Epub ahead of print]

Immunotherapy plus surgery/radiosurgery is associated with favorable survival in patients with melanoma brain metastasis.

Author information

1
Center for Dermatooncology, Department of Dermatology, University Hospital Tuebingen, Tuebingen, Germany.
2
Portuguese Air Force Health Direction, Paço do Lumiar, 1649-020, Lisbon, Portugal.
3
Department of Radiology, University Hospital Tuebingen, Tuebingen, Germany.
4
Department of Radiation Oncology, University Hospital Tuebingen, Tuebingen, Germany.
5
Centre for CNS Tumors at the Comprehensive Cancer Centre Tuebingen-Stuttgart, University Hospital Tuebingen, Tuebingen, Germany.
6
Interdisciplinary Division of Neuro-Oncology, Hertie Institute for Clinical Brain Research, University Hospital Tuebingen, Tuebingen, Germany.
7
Department of Neurosurgery, University Hospital Tuebingen, Tuebingen, Germany.

Abstract

AIM:

Melanoma brain metastases (MBM) are associated with a dismal prognosis. Few clinical trials evaluated the impact of immunotherapy (IT) and targeted therapy (TT) alone or in combination with surgery and radiotherapy in this population.

PATIENTS & METHODS:

Retrospective analysis of data from 163 patients diagnosed with MBM between January 2014 and December 2016. Prognostic factors of overall survival were analyzed using Kaplan-Meier survival curves, classification and regression tree and multivariate Cox regression analysis.

RESULTS:

The median follow-up was 25 months; median overall survival (mOS) for all patients was 7 months. For patients receiving IT, the mOS was 13 months and 7 months for patients receiving TT or chemotherapy (CT). The mOS for patients treated with surgery/radiosurgery in combination with IT, TT and CT was 25, 14 and 11 months, respectively.

CONCLUSION:

New systemic therapies, especially IT, improve mOS in patients with MBM, particularly when combined with surgery/radiosurgery upfront.

KEYWORDS:

chemotherapy; dominant systemic therapy; immunotherapy; melanoma brain metastases; overall survival; radiosurgery; stereotactic radiation; surgery; targeted therapy; whole brain irradiation

PMID:
30606066
DOI:
10.2217/imt-2018-0149

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