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Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma
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Patterns of disease control and survival in patients with melanoma brain metastases undergoing immune-checkpoint

Laura Milsch1, Anja Gesierich2, Sophia Kreft2

  • 1Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, 97080 Würzburg, Germany; Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Essen, Germany; German Cancer Consortium (DKTK), Heidelberg, Germany.

European Journal of Cancer (Oxford, England : 1990)
|June 16, 2018
PubMed
Abstract

Insights

Immune-checkpoint blockers (ICBs) show efficacy in melanoma with brain metastases, but extracranial disease control, not intracranial, predicts overall survival. Further research should explore quality of life and symptom control as key endpoints.

Area of Science:

  • Oncology
  • Immunotherapy
  • Melanoma Research

Background:

  • Immune-checkpoint blockers (ICBs) have improved outcomes for advanced melanoma.
  • Efficacy data for ICBs in patients with melanoma brain metastases (MBMs) are limited.
  • Understanding ICB activity in MBMs is crucial for treatment optimization.

Purpose of the Study:

  • To evaluate the efficacy of ICBs in an unselected cohort of patients with MBMs.
  • To determine if disease control in brain metastases correlates with overall survival (OS).
  • To identify predictive factors for treatment response in MBM patients.

Main Methods:

  • Retrospective analysis of 385 metastatic melanoma patients treated with ICB monotherapy (2005-2017).
  • Identification of 177 patients who developed MBMs.
  • Collection of demographic and clinical data, including extracranial (ec) and intracranial (ic) disease status.

Main Results:

  • Patients with MBMs had a poorer prognosis than those without, with worse survival for multiple brain metastases.
  • Extracranial disease control was significantly associated with improved OS in both MBM and non-MBM groups.
  • Intracranial disease control did not show a significant difference in OS compared to intracranial progression.

Conclusions:

  • Extracranial disease control is the primary predictor of OS in melanoma patients, irrespective of brain metastases.
  • Clinical trial endpoints for MBM patients should include quality of life and symptom control alongside intracranial response rates.
Keywords:
Brain metastasesImmune-checkpoint blockadeMelanoma

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