Changing Therapeutic Landscape for Melanoma With Multiple Brain Metastases.

Abstract:

:Over 90 000 people are expected to be diagnosed with melanoma in the United States this year. The development of brain metastases is particularly difficult to manage. Over the past few years, melanoma patients with multiple unresectable brain metastases for which stereotactic surgery might also not be a viable option have fortunately experienced a dramatic expansion in available management options given improvements made to targeted agents, immunotherapy, and radiotherapy. Whole-brain radiation therapy (WBRT) is a long-standing radiation technique that has become increasingly sophisticated. In this review, we summarize retrospective and prospective studies on individual advances in targeted agents, immunotherapy, and WBRT, highlighting important variables such as overall survival, intracranial progression-free survival, control and response rates, and toxicities. We also discuss the recent integration of these therapies into a multimodality approach, which has shown promise in the clinical setting although toxicities have not been insignificant. Finally, we describe ongoing prospective trials relevant to melanoma with brain metastases, and we conclude with our own thoughts on the optimal approach for these patients.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Jiang C,Wallington DG,Anker CJ,Lawson DH,Yushak ML,Kudchadkar RR,Tarhini A,Khan MK

doi

10.1093/neuros/nyaa076

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

498-515

issue

3

eissn

0148-396X

issn

1524-4040

pii

5823283

journal_volume

87

pub_type

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