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Burden and Risk Factors of Brain Metastases in Melanoma: A Systematic Literature Review
Xiang-Lin Tan1, Amy Le2, Huilin Tang3
1Merck & Co., Inc., Rahway, NJ 07065, USA.
Abstract:
Melanoma can frequently metastasize to the brain with severe consequences. However, variation of melanoma brain metastases (MBM) development among populations is not well studied, and underlying mechanisms and risk factors for MBM development are not consistently documented. We conducted a systematic literature review (SLR) including a total of 39 articles to evaluate the proportion of melanoma patients who are diagnosed with, or develop, brain metastases, and summarize the risk factors of MBM. The average proportion of MBM was calculated and weighted by the sample size of each study. Meta-analyses were conducted for the selected risk factors using a random-effects model. The proportion of MBM at diagnosis was 33% (975 with MBM out of 2948 patients) among patients with cutaneous melanoma (excluding acral) and 23% (651/2875) among patients with cutaneous mixed with other types of melanoma. The proportion at diagnosis was lower among populations with mucosal (9/96, 9%) or uveal (4/184, 2%) melanoma and among populations outside the United States and Europe. Meta-analysis demonstrated that male vs. female gender and left-sided tumors vs. right-sided were significantly associated with increased risk of melanoma brain metastases. These data may help clinicians to assess an individual patient's risk of developing melanoma brain metastases.
Insights
Melanoma frequently spreads to the brain, but risk factors vary. This study found male gender and left-sided tumors increase melanoma brain metastases risk, aiding clinical assessment.
Area of Science:
- Oncology
- Dermatology
- Neurology
Background:
- Melanoma brain metastases (MBM) are a common and severe complication of melanoma.
- Significant variations in MBM development exist across different populations, with poorly understood risk factors and mechanisms.
Purpose of the Study:
- To systematically review and quantify the proportion of melanoma patients developing MBM.
- To identify and summarize key risk factors associated with MBM development.
Main Methods:
- A systematic literature review (SLR) of 39 articles was performed.
- Proportions of MBM were calculated and weighted by study sample size.
- Meta-analyses were conducted for identified risk factors using a random-effects model.
Main Results:
- The proportion of MBM at diagnosis was 33% for cutaneous melanoma (excluding acral) and 23% for mixed types.
- MBM proportions were lower in mucosal (9%) and uveal (2%) melanoma, and in populations outside the US and Europe.
- Male gender and left-sided tumors were significantly associated with an increased risk of MBM.
Conclusions:
- This study provides crucial data on MBM prevalence and risk factors.
- Findings can assist clinicians in assessing individual patient risk for melanoma brain metastases.
