Oncology Central

Melanoma brain metastases: promising results for immune and targeted therapies combined with radiosurgery

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A study published recently in the Annals of Oncology has demonstrated the clinical benefit of treating melanoma brain metastases (MBM) with immune and targeted therapies in combination with stereotactic radiosurgery (SRS), in contrast to treating these patients with conventional chemotherapy.

The team of researchers from the Lee Moffitt Cancer Center and Research Institute (FL, USA) retrospectively analyzed data obtained from 96 patients to evaluate the effects of: single-session SRS along with anti-PD-1 therapy, BRAF/MEK inhibitors, anti-CTLA-4 therapy, BRAFi or conventional chemotherapy on the intracranial response rates in MBM patients.

Brain metastases are one of the most common and difficult to treat complications of melanoma. MBM carry a very poor prognosis, with an expected median survival of 4–5 months. In this study, the researchers demonstrated that treating MBM with SRS alongside anti-PD-1 therapy, anti-CTLA-4 therapy or BRAF/MEKi significantly improved overall survival and distant MBM control rates in comparison to conventional chemotherapy.

The lead study author Kamran Ahmed (Lee Moffitt Cancer Center and Research Institute) commented: “Conventional chemotherapy has failed to improve outcomes in patients with MBM. These results reveal that in patients with MBM, anti-PD-1 therapy and BRAF/MEK inhibitors alongside SRS offer optimal control of disease spread in the brain.”

“Although future randomized studies will be necessary to confirm the benefit of adding anti-PD-1 agents and BRAF/MEK inhibitors to SRS to improve the outcomes of patients with MBM, these results are encouraging,” Ahmed concluded.

The researchers noted that future studies should focus on evaluating the potential synergistic effect of the targeted immunological agents and SRS.

Sources: KA Ahmed, YA Abuodeh, MI Echevarria et al. Clinical Outcomes of Melanoma Brain Metastases Treated with Stereotactic Radiosurgery and Anti-PD-1 Therapy, Anti-CTLA-4 Therapy, BRAF/MEK Inhibitors, BRAF Inhibitor, or Conventional Chemotherapy,  Ann. Oncol. DOI: 10.1093/annonc/mdw417 (2016); Moffitt Cancer Center press release

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