How I treat brain metastases of melanoma

ESMO Open

article

Z. Eroglu¹  T.O. Topcu¹  H.M. Yu²  K.A. Margolin³ 

[1] Department of Cutaneous Oncology, Moffitt Cancer Center;Department of Radiation Oncology, Moffitt Cancer Center;Department of Medical Oncology, Providence St. John’s Cancer Institute

关键词: melanoma;    brain metastases;    immunotherapy;    targeted therapy;   

DOI  :  10.1016/j.esmoop.2022.100598

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

50% of patients. Until recently, median survival was only ∼4 months. Improved systemic treatment including immune checkpoint inhibitors and combinations of BRAF/MEK inhibitors, however, has significantly improved intracranial tumor response and survival. In addition, advances in radiation therapy have also improved the intracranial outcomes for advanced melanoma patients with brain metastases (MBM). There has long been concern that systemic treatment of the central nervous metastases would be ineffective due to inability of active agents to cross an intact blood–brain barrier. Recent studies have shown, however, that highly active systemic therapy can have significant benefit in these patients. When determining a patient's treatment, the important factors in predicting the likelihood of benefit including the presence of neurologic symptoms, the number and size of brain metastases, performance status/status of extracranial disease, and BRAF mutation status should all be considered. In this review, we will discuss the challenges and treatment options for patients with advanced melanoma and brain metastases.

【 授权许可】

CC BY|CC BY-NC-ND