scholarly journals The impact of current treatment modalities on the outcomes of patients with melanoma brain metastases: A systematic review

2019 ◽  
Vol 146 (6) ◽  
pp. 1479-1489 ◽  
Author(s):  
Mark P. Opijnen ◽  
Linda Dirven ◽  
Ida E.M. Coremans ◽  
Martin J.B. Taphoorn ◽  
Ellen H.W. Kapiteijn
Keyword(s):  
Systematic Review ◽  
Brain Metastases ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Melanoma Brain Metastases ◽  
The Impact

The impact of targeted therapies and immunotherapy in melanoma brain metastases: A systematic review and meta‐analysis

Cancer ◽  
2019 ◽  
Vol 125 (21) ◽  
pp. 3776-3789 ◽  
Author(s):  
Eliana Rulli ◽  
Lorenzo Legramandi ◽  
Lorenzo Salvati ◽  
Mario Mandala
Keyword(s):  
Systematic Review ◽  
Brain Metastases ◽  
Targeted Therapies ◽  
Meta Analysis ◽  
Melanoma Brain Metastases ◽  
The Impact

Abstract 4847: Investigating the impact of astrocytes on targeted therapy of melanoma brain metastases

2019 ◽  
Author(s):  
Joshua Parris ◽  
Subhasree Basu ◽  
Thibaut Barnoud ◽  
Yongkang Zhao ◽  
Peter Somboonsong ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Brain Metastases ◽  
Melanoma Brain Metastases ◽  
The Impact

New Era in the Management of Melanoma Brain Metastases

2018 ◽  
pp. 741-750 ◽  
Author(s):  
Hussein A. Tawbi ◽  
Celine Boutros ◽  
David Kok ◽  
Caroline Robert ◽  
Grant McArthur
Keyword(s):  
Brain Metastases ◽  
Systemic Therapy ◽  
Single Agent ◽  
Local Treatment ◽  
New Era ◽  
Therapeutic Modalities ◽  
Melanoma Brain Metastases ◽  
Extracranial Disease ◽  
Induce Response ◽  
The Impact

The remarkable advances in the systemic therapy of metastatic melanoma have now extended the 1-year overall survival rate from 25% to nearing 85%. Systemic treatment in the form of BRAF-targeted therapy and immunotherapy is slowly but surely proving its efficacy in the treatment of metatstatic brain metastases (MBM). Single-agent BRAF inhibitors provide an intracranial response rate of 25% to 40%, whereas the combination of BRAFi/MEKi leads to responses in up to 58%. However, the durability of responses induced by BRAFi/MEKi seems to be even shorter than in extracranial disease. On the other hand, single-agent ipilimumab provides comparable clinical benefit in MBMs as it does in extracranial metastases. Single-agent PD-1 anitbodies induce response rates of approximately 20%, and those responses appear durable. Similarly the combination of CTLA-4+ PD-1 antibodies induces durable responses at an impressive rate of 55% and is safe to administer. Although the local treatment approaches with radiation and surgery remain important and are critically needed in the management of MBM, systemic therapy offers a new dimension that can augment the impact of those therapies and come at a potentially lower cost of neurocognitive impairment. Considerations for combining those modalities are direly needed, in addition to considering novel systemic combinations that target mechanisms specific to MBM. In this report, we will discuss the underlying biology of melanoma brain metastases, the clinical outcomes from recent clinical trials of targeted and immunotherapy, and their impact on clinical practice in the context of existing local therapeutic modalities.

scholarly journals P.109 Increased survival when combining BRAF inhibitors and stereotactic radiosurgery in patients with melanoma brain metastases

2016 ◽  
Vol 43 (S2) ◽  
pp. S45-S46
Author(s):  
A Wolf ◽  
A Pavlick ◽  
M Wilson ◽  
J Silverman ◽  
D Kondziolka
Keyword(s):  
Overall Survival ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Systemic Disease ◽  
Braf Inhibitor ◽  
Braf Inhibitors ◽  
Actuarial Survival ◽  
Early Management ◽  
Melanoma Brain Metastases ◽  
The Impact

Background: The purpose of the study was to evaluate the impact of BRAF inhibitors on survival outcomes in patients receiving stereotactic radiosurgery (SRS) for melanoma brain metastases. Methods: We prospectively collected treatment outcomes for 80 patients with melanoma brain metastases who underwent SRS. Thirty-five patients harbored the BRAF mutation (BRAF-M) and 45 patients did not (BRAF-WT). Results: The median overall survival from first SRS procedure was 11.2 months if treated with a BRAF inhibitor and 4.5 months for BRAF-WT. Actuarial survival rates for BRAF-M patients on an inhibitor were 54% and 41% at 6 and 12 months after radiosurgery, in contrast to 28% and 19% for BRAF-WT. Overall survival was extended for patients on a BRAF inhibitor if initiated at or after the first SRS. The local control rate did not differ based on BRAF status and was over 90%. Patients with higher KPS, fewer treated metastases, controlled systemic disease, RPA class 1 and BRAF-M patients had extended overall survival. Conclusions: Patients with BRAF-M treated with both SRS and BRAF inhibitors, at or after SRS, have increased overall survival. As patients live longer due to more effective systemic and local therapies, close surveillance and early management of intracranial disease with SRS will become increasingly important.

scholarly journals Combination of radiotherapy and targeted therapy for melanoma brain metastases: a systematic review

2021 ◽  
Vol 31 (5) ◽  
pp. 413-420
Author(s):  
Yi Ge ◽  
Xuanlin Che ◽  
Xin Gao ◽  
Shuang Zhao ◽  
Juan Su
Keyword(s):  
Systematic Review ◽  
Targeted Therapy ◽  
Brain Metastases ◽  
Melanoma Brain Metastases

Improved palliation of cerebral metastases in epithelial ovarian cancer using a combined modality approach including radiation therapy, chemotherapy, and surgery.

1992 ◽  
Vol 10 (10) ◽  
pp. 1553-1560 ◽  
Author(s):  
G C Rodriguez ◽  
J T Soper ◽  
A Berchuck ◽  
J Oleson ◽  
R Dodge ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Radiation Therapy ◽  
Brain Metastases ◽  
Ovarian Carcinoma ◽  
Epithelial Ovarian Cancer ◽  
Systemic Chemotherapy ◽  
Treatment Modalities ◽  
Current Series ◽  
Clinical Series ◽  
The Impact

PURPOSE Recent reports suggest an increasing incidence of CNS metastases in patients with ovarian cancer. We reviewed our experience in the management of brain metastases from ovarian carcinoma and merged our results with those of several other series reported in the literature to determine prognostic factors and the role of chemotherapy, radiation therapy, and surgery. PATIENTS AND METHODS From 1977 to 1990, 15 of 795 patients who were treated for epithelial ovarian cancer at Duke University developed brain metastases. Fourteen of the patients were treated for their brain metastases; this included radiation therapy (RT; four), surgery and RT (one), RT and systemic chemotherapy (six), and all three treatment modalities (three). A meta-analysis was performed that combined the data from the current series with those of several recent clinical series that reviewed patients with brain metastases from ovarian carcinoma (67 patients total) to elucidate the impact of treatment and extent of disease on survival. RESULTS In the current series, median survival (MS) after the diagnosis of brain metastases was 9 months. For the combined series, MS was 5 months. Thirteen patients who were treated with whole-brain RT and systemic chemotherapy (MS, 7 months), 10 patients who were treated with RT and surgery (MS, 10 months), and nine patients who were treated with all three modalities (MS, 16.5 months) had significantly longer survival than 19 patients who were treated with RT alone (MS, 3 months) (P = .05, P = .01, and P < .001, respectively). In a multivariate analysis, the only variable that provided prognostic information was treatment, namely the addition of systemic chemotherapy or surgery to RT for the treatment of brain metastases. CONCLUSION Multimodal treatment of patients with brain metastases from ovarian cancer can result in significant palliation.

Melanoma Brain Metastases: The Impact of Nodal Disease

2012 ◽  
Vol 84 (3) ◽  
pp. S655
Author(s):  
J. Jackson ◽  
B.H. Burmeister ◽  
E. Burmeister ◽  
M.C. Foote ◽  
J.M. Thomas ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Nodal Disease ◽  
Melanoma Brain Metastases ◽  
The Impact
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