Abstract 3991
Background
The effectiveness of conventional chemotherapy (temozolomide, fotemustine, lomustine) alone and its combinations with radiation therapy in patients with melanoma with cerebral metastases does not exceed 7-10%, There is no significant impact on overall survival, which is 2-4 month. Research of immunotherapy (nivolumab, ipilimumab, pembrolizumab) is relevant in melanoma patients with brain metastases in the absence of mutations of the BRAF, or in the case of the progression of the disease while therapy BRAF inhibitors in patients with mutations of the BRAF.
Methods
The effect of the various schemes immunotherapy was evaluated in 22 patients with melanoma with brain metastases in Russian N.N. Blokhin Cancer Research Center. Patients received the following treatment options: nivolumab (6 patients), ipilimumab (11 patients), nivolumab + ipilimumab (2 patients), pembrolizumab (3 patients). The immunotherapy was combined with whole brain irradiation in 1 patient (4,5%), in 11 patients (50,0%) – in combination with stereotactic radiotherapy/radiosurgery.
Results
Complete regression of brain metastases was achieved in 3 patients (13,6%), partial regression in 2 (9,1%), stabilization in 11 (50,0%). Thus, the tumor control in the brain was observed in 16 patients (72,7%). In 22 patients (100,0%) were also established metastases in other sites (extracranial lesions). Complete regression of metastases in extracranial lesions was achieved in 4 patients (18,2%), partial regression – in 2 (9,1%), stabilization in 13 (59,1%). The median time to disease progression was 5,0 months. The median survival of patients was 10,0 months.
Conclusions
The preliminary results of our study show that the application of immunotherapy, including the combination with local control of metastases in the brain in patients with melanoma with brain metastases provides control over the disease in most patients and has a significant advantage with a group of historical control (chemotherapy ± whole brain irradiation).
Clinical trial identification
Legal entity responsible for the study
Russian N.N. Blokhin Cancer Research Center.
Funding
Russian N.N. Blokhin Cancer Research Center.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
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