Impact of immunotherapy among patients with melanoma brain metastases managed with radiotherapy

William A Stokes; David C Binder; Bernard L Jones; Ayman J Oweida; Arthur K Liu; Chad G Rusthoven; Sana D Karam

doi:10.1016/j.jneuroim.2017.10.006

Impact of immunotherapy among patients with melanoma brain metastases managed with radiotherapy

J Neuroimmunol. 2017 Dec 15:313:118-122. doi: 10.1016/j.jneuroim.2017.10.006. Epub 2017 Oct 13.

Authors

William A Stokes¹, David C Binder², Bernard L Jones³, Ayman J Oweida⁴, Arthur K Liu⁵, Chad G Rusthoven⁶, Sana D Karam⁷

Affiliations

¹ Department of Radiation Oncology, University of Colorado Denver School of Medicine, Aurora, CO, USA. Electronic address: william.stokes@ucdenver.edu.
² Department of Radiation Oncology, University of Colorado Denver School of Medicine, Aurora, CO, USA. Electronic address: david.binder@ucdenver.edu.
³ Department of Radiation Oncology, University of Colorado Denver School of Medicine, Aurora, CO, USA. Electronic address: bernard.jones@ucdenver.edu.
⁴ Department of Radiation Oncology, University of Colorado Denver School of Medicine, Aurora, CO, USA. Electronic address: ayman.oweida@ucdenver.eduu.
⁵ Department of Radiation Oncology, University of Colorado Denver School of Medicine, Aurora, CO, USA. Electronic address: arthur.liu@ucdenver.edu.
⁶ Department of Radiation Oncology, University of Colorado Denver School of Medicine, Aurora, CO, USA. Electronic address: chad.rusthoven@ucdenver.edu.
⁷ Department of Radiation Oncology, University of Colorado Denver School of Medicine, Aurora, CO, USA. Electronic address: sana.karam@ucdenver.edu.

PMID: 29153603
DOI: 10.1016/j.jneuroim.2017.10.006

Abstract

Background: Patients with melanoma brain metastases (MBM) have been excluded from trials evaluating immunotherapy in melanoma. As such, immunotherapy's role in MBM is poorly understood, particularly in combination with radiotherapy.

Methods: The National Cancer Database was queried for patients with MBM receiving brain radiotherapy. They were classified according to immunotherapy receipt. Multivariate Cox regression was performed to identify factors associated with survival.

Results: Among 1287 patients, 185 received immunotherapy. Factors associated with improved survival included younger age, academic facility, lower extracranial disease burden, stereotactic radiotherapy, chemotherapy, and immunotherapy.

Conclusions: Adding immunotherapy to radiotherapy for MBM is associated with improved survival.

Keywords: Brain metastases; Immunotherapy; Melanoma; Stereotactic radiosurgery; Whole-brain radiotherapy.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Age Distribution
Aged
Brain Neoplasms / mortality
Brain Neoplasms / secondary*
Brain Neoplasms / therapy*
Cranial Irradiation / methods*
Databases, Factual / statistics & numerical data
Female
Humans
Immunotherapy / methods*
Kaplan-Meier Estimate
Male
Melanoma / pathology*
Middle Aged