Survival and clinical outcomes of patients with melanoma brain metastasis in the era of checkpoint inhibitors and targeted therapies
Abstract Background Melanoma brain metastasis is associated with an extremely poor prognosis, with a median overall survival of 4–5 months. Since 2011, the overall survival of patients with stage IV melanoma has been significantly improved with the advent of new targeted therapies and checkpoint inh...
Main Authors: | , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2018-04-01
|
Series: | BMC Cancer |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12885-018-4374-x |
id |
doaj-486e831d368142f881409d2a8c76d6ac |
---|---|
record_format |
Article |
spelling |
doaj-486e831d368142f881409d2a8c76d6ac2020-11-24T22:16:19ZengBMCBMC Cancer1471-24072018-04-011811710.1186/s12885-018-4374-xSurvival and clinical outcomes of patients with melanoma brain metastasis in the era of checkpoint inhibitors and targeted therapiesElham Vosoughi0Jee Min Lee1James R. Miller2Mehdi Nosrati3David R. Minor4Roy Abendroth5John W. Lee6Brian T. Andrews7Lewis Z. Leng8Max Wu9Stanley P. Leong10Mohammed Kashani-Sabet11Kevin B. Kim12Center for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteCenter for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteCenter for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteCenter for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteCenter for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteCenter for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteCenter for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteCenter for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteCenter for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteCenter for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteCenter for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteCenter for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteCenter for Melanoma Research and Treatment, California Pacific Medical Center Research InstituteAbstract Background Melanoma brain metastasis is associated with an extremely poor prognosis, with a median overall survival of 4–5 months. Since 2011, the overall survival of patients with stage IV melanoma has been significantly improved with the advent of new targeted therapies and checkpoint inhibitors. We analyze the survival outcomes of patients diagnosed with brain metastasis after the introduction of these novel drugs. Methods We performed a retrospective analysis of our melanoma center database and identified 79 patients with brain metastasis between 2011 and 2015. Results The median time from primary melanoma diagnosis to brain metastasis was 3.2 years. The median overall survival duration from the time of initial brain metastasis was 12.8 months. Following a diagnosis of brain metastasis, 39 (49.4%), 28 (35.4%), and 24 (30.4%) patients were treated with anti-CTLA-4 antibody, anti-PD-1 antibody, or BRAF inhibitors (with or without a MEK inhibitor), with a median overall survival of 19.2 months, 37.9 months and 12.7 months, respectively. Factors associated with significantly reduced overall survival included male sex, cerebellar metastasis, higher number of brain lesions, and treatment with whole-brain radiation therapy. Factors associated with significantly longer overall survival included treatment with craniotomy, stereotactic radiosurgery, or with anti-PD-1 antibody after initial diagnosis of brain metastasis. Conclusions These results show a significant improvement in the overall survival of patients with melanoma brain metastasis in the era of novel therapies. In addition, they suggest the activity of anti-PD-1 therapy specifically in the setting of brain metastasis.http://link.springer.com/article/10.1186/s12885-018-4374-xMelanomaBrainMetastasisCheckpoint inhibitorsBRAF |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Elham Vosoughi Jee Min Lee James R. Miller Mehdi Nosrati David R. Minor Roy Abendroth John W. Lee Brian T. Andrews Lewis Z. Leng Max Wu Stanley P. Leong Mohammed Kashani-Sabet Kevin B. Kim |
spellingShingle |
Elham Vosoughi Jee Min Lee James R. Miller Mehdi Nosrati David R. Minor Roy Abendroth John W. Lee Brian T. Andrews Lewis Z. Leng Max Wu Stanley P. Leong Mohammed Kashani-Sabet Kevin B. Kim Survival and clinical outcomes of patients with melanoma brain metastasis in the era of checkpoint inhibitors and targeted therapies BMC Cancer Melanoma Brain Metastasis Checkpoint inhibitors BRAF |
author_facet |
Elham Vosoughi Jee Min Lee James R. Miller Mehdi Nosrati David R. Minor Roy Abendroth John W. Lee Brian T. Andrews Lewis Z. Leng Max Wu Stanley P. Leong Mohammed Kashani-Sabet Kevin B. Kim |
author_sort |
Elham Vosoughi |
title |
Survival and clinical outcomes of patients with melanoma brain metastasis in the era of checkpoint inhibitors and targeted therapies |
title_short |
Survival and clinical outcomes of patients with melanoma brain metastasis in the era of checkpoint inhibitors and targeted therapies |
title_full |
Survival and clinical outcomes of patients with melanoma brain metastasis in the era of checkpoint inhibitors and targeted therapies |
title_fullStr |
Survival and clinical outcomes of patients with melanoma brain metastasis in the era of checkpoint inhibitors and targeted therapies |
title_full_unstemmed |
Survival and clinical outcomes of patients with melanoma brain metastasis in the era of checkpoint inhibitors and targeted therapies |
title_sort |
survival and clinical outcomes of patients with melanoma brain metastasis in the era of checkpoint inhibitors and targeted therapies |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2018-04-01 |
description |
Abstract Background Melanoma brain metastasis is associated with an extremely poor prognosis, with a median overall survival of 4–5 months. Since 2011, the overall survival of patients with stage IV melanoma has been significantly improved with the advent of new targeted therapies and checkpoint inhibitors. We analyze the survival outcomes of patients diagnosed with brain metastasis after the introduction of these novel drugs. Methods We performed a retrospective analysis of our melanoma center database and identified 79 patients with brain metastasis between 2011 and 2015. Results The median time from primary melanoma diagnosis to brain metastasis was 3.2 years. The median overall survival duration from the time of initial brain metastasis was 12.8 months. Following a diagnosis of brain metastasis, 39 (49.4%), 28 (35.4%), and 24 (30.4%) patients were treated with anti-CTLA-4 antibody, anti-PD-1 antibody, or BRAF inhibitors (with or without a MEK inhibitor), with a median overall survival of 19.2 months, 37.9 months and 12.7 months, respectively. Factors associated with significantly reduced overall survival included male sex, cerebellar metastasis, higher number of brain lesions, and treatment with whole-brain radiation therapy. Factors associated with significantly longer overall survival included treatment with craniotomy, stereotactic radiosurgery, or with anti-PD-1 antibody after initial diagnosis of brain metastasis. Conclusions These results show a significant improvement in the overall survival of patients with melanoma brain metastasis in the era of novel therapies. In addition, they suggest the activity of anti-PD-1 therapy specifically in the setting of brain metastasis. |
topic |
Melanoma Brain Metastasis Checkpoint inhibitors BRAF |
url |
http://link.springer.com/article/10.1186/s12885-018-4374-x |
work_keys_str_mv |
AT elhamvosoughi survivalandclinicaloutcomesofpatientswithmelanomabrainmetastasisintheeraofcheckpointinhibitorsandtargetedtherapies AT jeeminlee survivalandclinicaloutcomesofpatientswithmelanomabrainmetastasisintheeraofcheckpointinhibitorsandtargetedtherapies AT jamesrmiller survivalandclinicaloutcomesofpatientswithmelanomabrainmetastasisintheeraofcheckpointinhibitorsandtargetedtherapies AT mehdinosrati survivalandclinicaloutcomesofpatientswithmelanomabrainmetastasisintheeraofcheckpointinhibitorsandtargetedtherapies AT davidrminor survivalandclinicaloutcomesofpatientswithmelanomabrainmetastasisintheeraofcheckpointinhibitorsandtargetedtherapies AT royabendroth survivalandclinicaloutcomesofpatientswithmelanomabrainmetastasisintheeraofcheckpointinhibitorsandtargetedtherapies AT johnwlee survivalandclinicaloutcomesofpatientswithmelanomabrainmetastasisintheeraofcheckpointinhibitorsandtargetedtherapies AT briantandrews survivalandclinicaloutcomesofpatientswithmelanomabrainmetastasisintheeraofcheckpointinhibitorsandtargetedtherapies AT lewiszleng survivalandclinicaloutcomesofpatientswithmelanomabrainmetastasisintheeraofcheckpointinhibitorsandtargetedtherapies AT maxwu survivalandclinicaloutcomesofpatientswithmelanomabrainmetastasisintheeraofcheckpointinhibitorsandtargetedtherapies AT stanleypleong survivalandclinicaloutcomesofpatientswithmelanomabrainmetastasisintheeraofcheckpointinhibitorsandtargetedtherapies AT mohammedkashanisabet survivalandclinicaloutcomesofpatientswithmelanomabrainmetastasisintheeraofcheckpointinhibitorsandtargetedtherapies AT kevinbkim survivalandclinicaloutcomesofpatientswithmelanomabrainmetastasisintheeraofcheckpointinhibitorsandtargetedtherapies |
_version_ |
1725790727044071424 |