[Systemic treatment of melanoma brain metastases]

Cancer Radiother. 2015 Feb;19(1):48-54. doi: 10.1016/j.canrad.2014.11.010. Epub 2015 Feb 2.
[Article in French]

Abstract

Melanomas have a high rate of brain metastases. Both the functional prognosis and the overall survival are poor in these patients. Until now, surgery and radiotherapy represented the two main modalities of treatment. Nevertheless, due to the improvement in the management of the extracerebral melanoma, the systemic treatment may be an option in patients with brain metastases. Immunotherapy with anti-CTLA4 (cytotoxic T-lymphocyte-associated protein 4) - ipilimumab - or BRAF (serine/threonine-protein kinase B-raf) inhibitors - vemurafenib, dabrafenib - has shown efficacy in the management of brain metastases in a- or pauci-symptomatic patients. Studies are ongoing with anti-PD1 (programmed cell death 1) and combinations of targeted therapies associating anti-RAF (raf proto-oncogene, serine/threonine kinase) and anti-MEK (mitogen-activated protein kinase kinase).

Keywords: BRAF inhibitors; Brain metastases; Inhibiteurs de BRAF; Ipilimumab; Melanoma; Mélanome; Métastases cérébrales.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Abatacept
  • Angiogenesis Inhibitors / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Brain Neoplasms / drug therapy
  • Brain Neoplasms / genetics
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / therapy
  • CTLA-4 Antigen / antagonists & inhibitors
  • Clinical Trials, Phase II as Topic
  • Dacarbazine / therapeutic use
  • Humans
  • Imidazoles / therapeutic use
  • Immunoconjugates / therapeutic use
  • Immunotherapy
  • Indoles / therapeutic use
  • Interleukin-2 / therapeutic use
  • Ipilimumab
  • Melanoma / drug therapy
  • Melanoma / genetics
  • Melanoma / secondary*
  • Melanoma / therapy
  • Molecular Targeted Therapy
  • Neoplasm Proteins / antagonists & inhibitors
  • Oximes / therapeutic use
  • Point Mutation
  • Protein Kinase Inhibitors
  • Proto-Oncogene Mas
  • Proto-Oncogene Proteins B-raf / antagonists & inhibitors
  • Sulfonamides / therapeutic use
  • Vemurafenib

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • CTLA-4 Antigen
  • CTLA4 protein, human
  • Imidazoles
  • Immunoconjugates
  • Indoles
  • Interleukin-2
  • Ipilimumab
  • MAS1 protein, human
  • Neoplasm Proteins
  • Oximes
  • Protein Kinase Inhibitors
  • Proto-Oncogene Mas
  • Sulfonamides
  • Vemurafenib
  • Abatacept
  • Dacarbazine
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • dabrafenib