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Poster display session

3245 - Tolerance and outcomes of stereotactic radiosurgery combined with anti-PD1 (pembrolizumab) for melanoma brain metastases.

Date

10 Sep 2017

Session

Poster display session

Presenters

Charlée Nardin

Citation

Annals of Oncology (2017) 28 (suppl_5): v428-v448. 10.1093/annonc/mdx377

Authors

C. Nardin1, C. Mateus1, M. Texier2, E. Lanoy2, S. Hibat-Allah3, S. Ammari3, C. Robert1, F. Dhermain4

Author affiliations

  • 1 Dermatologie, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 2 Biostatistiques Et Epidémiologie, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 3 Radiologie, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 4 Radiothérapie, Institut Gustave Roussy, 94800 - Villejuif/FR
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Resources

Abstract 3245

Background

Anti-PD1 antibodies are currently the first-line treatment for patients with metastatic BRAF wild-type melanoma, alone or combined with the anti-CTLA4 mAb, ipilimumab. To date, data on safety and the outcomes of patients treated with the anti-PD1 mAbs, pembrolizumab (PB) or nivolumab, combined with stereotactic radiosurgery (SRS) for melanoma brain metastases (MBM) are lacking.

Methods

Patients with MBM treated with PB combined with SRS between 2012 and 2015 were retrospectively reviewed. The primary endpoint was neurotoxicity. The secondary endpoints were local control, distant intracranial control and overall survival (OS).

Results

Among 74 patients with MBM treated with SRS, 25 patients with a total of 58 MBM treated with PB combined with SRS within 6 months were included. Radionecrosis, occurring within a median time of 6.5 months, was observed in four metastases (6.8%) in four different patients. No significant other SRS-related adverse event had been reported. After a median follow-up of 8.4 months, local control had been achieved in 46 metastases (80%). The median time to local progression was 2 months. Perilesional oedema and intratumour haemorrhage appearing or increasing after SRS were mostly associated with local progression (P 

Conclusions

SRS combined with PB was well tolerated and achieved high local control as recently described with SRS and nivolumab. Prolonged OS were achieved compared to that currently yielded with recommended treatments. Prospective studies are required to confirm these results and define the best timing between SRS and PB for the management of MBM.

Clinical trial identification

Legal entity responsible for the study

Caroline Robert, Gustave Roussy

Funding

None

Disclosure

All authors have declared no conflicts of interest.

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