Dataset Information

Melanoma central nervous system metastases: An update to approaches, challenges, and opportunities.

ABSTRACT: In February 2018, the Melanoma Research Foundation and the Moffitt Cancer Center hosted the Second Summit on Melanoma Central Nervous System (CNS) Metastases in Tampa, Florida. In this white paper, we outline the current status of basic science, translational, and clinical research into melanoma brain metastasis development and therapeutic management. We further outline the important challenges that remain for the field and the critical barriers that need to be overcome for continued progress to be made in this clinically difficult area.

SUBMITTER: Eroglu Z

PROVIDER: S-EPMC7771318 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Melanoma central nervous system metastases: An update to approaches, challenges, and opportunities.

Eroglu Zeynep Z Holmen Sheri L SL Chen Qing Q Khushalani Nikhil I NI Amaravadi Ravi R Thomas Reena R Ahmed Kamran A KA Tawbi Hussein H Chandra Sunandana S Markowitz Joseph J Smalley Inna I Liu James K C JKC Chen Yian Ann YA Najjar Yana G YG Karreth Florian A FA Abate-Daga Daniel D Glitza Isabella C IC Sosman Jeffrey A JA Sondak Vernon K VK Bosenberg Marcus M Herlyn Meenhard M Atkins Michael B MB Kluger Harriet H Margolin Kim K Forsyth Peter A PA Davies Michael A MA Smalley Keiran S M KSM

Pigment cell & melanoma research 20190219 3

In February 2018, the Melanoma Research Foundation and the Moffitt Cancer Center hosted the Second Summit on Melanoma Central Nervous System (CNS) Metastases in Tampa, Florida. In this white paper, we outline the current status of basic science, translational, and clinical research into melanoma brain metastasis development and therapeutic management. We further outline the important challenges that remain for the field and the critical barriers that need to be overcome for continued progress to ...[more]

PMID: 30712316

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Project description:BackgroundPatients with melanoma and central nervous system (CNS) metastases have poor survival outcomes. We investigated real-world treatment patterns and overall survival (OS) of patients with melanoma and CNS metastases.MethodsA retrospective analysis utilizing a nationwide de-identified electronic health record-derived database was undertaken in patients diagnosed with advanced melanoma between January 2011 and September 2018. Patients with any visit ≤90 days of metastatic diagnosis and with confirmed CNS metastases were included.ResultsOf 3473 patients diagnosed with advanced melanoma, 791 patients with confirmed CNS metastases were identified and included in this analysis. Synchronous CNS metastasis (≤30 days of metastatic diagnosis) was associated with longer median OS than metachronous CNS metastasis (>30 days after metastatic diagnosis, 0.58 vs 0.42 years). Stereotactic radiosurgery (SRS) was the most common treatment (40.5%) alone or in combination with other local or systemic therapies, being more frequent in patients diagnosed in 2015+ versus 2011-2014 (44.1% vs 35.5%, respectively). The most common systemic treatment was immune checkpoint inhibitors (ICIs; 30.5%), predominantly anti-cytotoxic T-lymphocyte antigen 4 (CTLA-4) alone (2011-2014) and anti-programmed death-1 alone or in combination with anti-CTLA-4 (2015+). Median OS was longest in SRS-treated patients (1.17 years) regardless of number of CNS metastases. Median OS for SRS-treated patients increased from 0.83 years (2011-2014) to 1.75 years (2015+). In multivariable analysis, the effect of SRS remained significant after adjustment for sex, race, intracranial and extracranial disease burden, and timing of CNS metastases. Interaction testing to examine potential synergy between SRS/whole-brain radiation therapy and ICIs found no significant interaction.ConclusionsDespite advances in treatment, patients with melanoma and CNS metastases have poor survival outcomes. Prevalence of SRS increased over time and was associated with improved outcomes.

Dataset Information

Melanoma central nervous system metastases: An update to approaches, challenges, and opportunities.

Publications

Melanoma central nervous system metastases: An update to approaches, challenges, and opportunities.

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