Impact of immunotherapy among patients with melanoma brain metastases managed with radiotherapy

Patients with melanoma brain metastases (MBM) have been excluded from trials evaluating immunotherapy in melanoma. As such, immunotherapy's role in MBM is poorly understood, particularly in combination with radiotherapy. The National Cancer Database was queried for patients with MBM receiving b...

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Bibliographic Details
Published in:Journal of neuroimmunology 2017-12, Vol.313, p.118-122
Main Authors: Stokes, William A., Binder, David C., Jones, Bernard L., Oweida, Ayman J., Liu, Arthur K., Rusthoven, Chad G., Karam, Sana D.
Format: Article
Language:English
Subjects:
Adult
Age Distribution
Aged
Brain metastases
Brain Neoplasms - mortality
Brain Neoplasms - secondary
Brain Neoplasms - therapy
Cranial Irradiation - methods
Databases, Factual - statistics & numerical data
Female
Humans
Immunotherapy
Immunotherapy - methods
Kaplan-Meier Estimate
Male
Melanoma
Melanoma - pathology
Middle Aged
Stereotactic radiosurgery
Whole-brain radiotherapy
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Summary:Patients with melanoma brain metastases (MBM) have been excluded from trials evaluating immunotherapy in melanoma. As such, immunotherapy's role in MBM is poorly understood, particularly in combination with radiotherapy. The National Cancer Database was queried for patients with MBM receiving brain radiotherapy. They were classified according to immunotherapy receipt. Multivariate Cox regression was performed to identify factors associated with survival. Among 1287 patients, 185 received immunotherapy. Factors associated with improved survival included younger age, academic facility, lower extracranial disease burden, stereotactic radiotherapy, chemotherapy, and immunotherapy. Adding immunotherapy to radiotherapy for MBM is associated with improved survival. [Display omitted] •Trials leading to the approval of immunotherapy for metastatic melanoma have excluded patients with brain metastases.•In a large dataset, receipt of immunotherapy is associated with a survival advantage in these patients.•This advantage appeared consistent across multiple subgroups of clinical interest.
ISSN:0165-5728
1872-8421
DOI:10.1016/j.jneuroim.2017.10.006