Survival of patients with metastatic melanoma and
brain metastases in the era of MAP-kinase inhibitors and immunologic checkpoint
blockade antibodies: A systematic review.
Spagnolo,
Picasso, Lambertini, et al. Cancer Treat Rev. 2016 Mar 8;45:38-45.
The incidence of brain
metastases (BM) in melanoma patients is common and associated with poor
prognosis. MAP-kinase inhibitors and immunologic checkpoint blockade antibodies
led to improved survival of metastatic melanoma patients; however, patients
with BM are under-represented or excluded from the majority of clinical trials
and the impact of new drugs on their survival is less clear. With the present
systematic review, we aimed to analyze outcomes of patients with melanoma BM
treated with the new drugs, both in the setting of phase I-II-III clinical
trials and in the "real world".
An electronic search was
performed to identify studies reporting survival outcomes of patients with
melanoma BM treated with MAP-kinase inhibitors and/or immunologic checkpoint
blockade antibodies, regardless of study design. Twenty-two studies were included for a total
of 2153 patients. Median OS was 7.9 months in phase I-II-III trials and 7.7 months
in "real world" studies. In clinical trials, median OS was 7 months
for patients treated with immunotherapy and 7.9 months for patients treated
with BRAF inhibitors. In "real world" studies, median OS was 4.3 months
and 7.7 months for patients treated with immunotherapy and BRAF inhibitors,
respectively. Evidence of clinical activity exists for both immunotherapy and
MAP-kinase inhibitors.
Someday I won't have to keep repeating this!!! Sadly, just read an article in Time that said there was no proof that pembro worked on brain mets! Good grief!!!! But....I'm still here after a melanoma brain met in 2010!!! - c
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