Melanoma Brain Metastases in the Era of Targeted Therapy and Checkpoint Inhibitor Therapy

Cancers

JohnM. Rieth¹  Marion Vanneste²  MichaelD. Henry²  Brooke Jennings²  Mario Zanaty³  JeremyD. Greenlee³  AaronD. Bossler⁴  Umang Swami⁵  Yousef Zakharia⁶  MohammedM. Milhem⁶  SarahL. Mott⁶ 

[1] Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA;Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA;Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA;Department of Pathology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA;Health Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA;Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, University of Iowa, Iowa City, IA 52242, USA;

关键词: melanoma;    prognosis;    cancer management;    clinical cancer research;    metastasis;    survival;   

DOI  :  10.3390/cancers13071489

来源: DOAJ

【 摘 要 】

Brain metastases commonly develop in melanoma and are associated with poor overall survival of about five to nine months. Fortunately, new therapies, including immune checkpoint inhibitors and BRAF/MEK inhibitors, have been developed. The aim of this study was to identify outcomes of different treatment strategies in patients with melanoma brain metastases in the era of checkpoint inhibitors. Patients with brain metastases secondary to melanoma were identified at a single institution. Univariate and multivariable analyses were performed to identify baseline and treatment factors, which correlated with progression-free and overall survival. A total of 209 patients with melanoma brain metastases were identified. The median overall survival of the cohort was 5.3 months. On multivariable analysis, the presence of non-cranial metastatic disease, poor performance status (ECOG 2–4), whole-brain radiation therapy, and older age at diagnosis of brain metastasis were associated with poorer overall survival. Craniotomy (HR 0.66, 95% CI 0.45–0.97) and treatment with a CTLA-4 checkpoint inhibitor (HR 0.55, 95% CI 0.32–0.94) were the only interventions associated with improved overall survival. Further studies with novel agents are needed to extend lifespan in patients with brain metastases in melanoma.

【 授权许可】

Unknown