Brief Report(s)
Vol. 10 (2022)
The management of brain metastases in melanoma patients
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: 2 February 2022
Accepted: 5 April 2022
Accepted: 5 April 2022
634
Views
329
Downloads
Authors
Among solid tumors, melanoma is the most aggressive form of skin cancer, with the highest risk of developing brain metastasis. The central nervous system is the most frequent initial site of treatment failure, both with chemotherapy and with biological therapies.
The combination of antiCTLA4 and antiPD1 is superior to single agents alone in terms of rapidity and duration of responses, although its activity is limited in symptomatic patients.
Target therapy induces rapid responses in a significant proportion of patients, but these are generally short-lasting.
Currently, there is a great interest in evaluating the combination with new immunotherapy and antiangiogenic agents, with sequential or concomitant radiotherapy.
Multidisciplinary management of patients with melanoma brain metastasis is crucial to provide the best treatment in the context of a patient-centered approach.
Downloads
Download data is not yet available.
Citations
Ali Z, Yousaf N, Larkin J. Melanoma epidemiology, biology and prognosis. EJC Suppl. 2013;11:81–91. DOI: https://doi.org/10.1016/j.ejcsup.2013.07.012
Leonardi GC, Falzone L, Salemi R, et al. Cutaneous melanoma: From pathogenesis to therapy (Review). Int J Oncol. 2018;52:1071-1080. DOI: https://doi.org/10.3892/ijo.2018.4287
Rastrelli M, Tropea S, Rossi CR, et al. Melanoma: Epidemiology, risk factors, pathogenesis, diagnosis and classification. In Vivo. 2014;28:1005–1011.
Gilchrest BA, Eller MS, Geller AC, et al. The pathogenesis of melanoma induced by ultraviolet radiation. N Engl J Med. 1999;340:1341–1348. DOI: https://doi.org/10.1056/NEJM199904293401707
Pennello G, Devesa S, Gail M. Association of surface ultraviolet B radiation levels with melanoma and nonmelanoma skin cancer in United States blacks. Cancer Epidemiol Biomarkers Prev. 2000;9:291–297.
Falzone L, Marconi A, Loreto C, et al. Occupational exposure to carcinogens: Benzene, pesticides and fibers (Review) Mol Med Rep. 2016;14:4467–4474. DOI: https://doi.org/10.3892/mmr.2016.5791
Bauer J, Garbe C. Acquired melanocytic nevi as risk factor for melanoma development. A comprehensive review of epidemiological data. Pigment Cell Res. 2003;16:297–306. DOI: https://doi.org/10.1034/j.1600-0749.2003.00047.x
Russo AE, Torrisi E, Bevelacqua Y, et al. Melanoma: Molecular pathogenesis and emerging target therapies (Review). Int J Oncol. 2009;34:1481–1489. DOI: https://doi.org/10.3892/ijo_00000277
Hawkes JE, Truong A, Meyer LJ. Genetic predisposition to melanoma. Semin Oncol. 2016;43:591–597. DOI: https://doi.org/10.1053/j.seminoncol.2016.08.003
Bevona C, Goggins W, Quinn T, et al. Cutaneous melanomas associated with nevi. Arch Dermatol. 2003;139:1620–1624. DOI: https://doi.org/10.1001/archderm.139.12.1620
Cohen JV, Tawbi H, Margolin KA, et al. Melanoma central nervous system metastases: current approaches, challenges, and opportunities. Pigment Cell Melanoma Res. 2016;29:627-642. DOI: https://doi.org/10.1111/pcmr.12538
Sampson JH, Carter JH, Friedman AH, et al. Demographics, prognosis, and therapy in 702 patients with brain metastases from malignant melanoma. J Neurosurg. 1998;88:11-20. DOI: https://doi.org/10.3171/jns.1998.88.1.0011
Long GV, Margolin KA. Multidisciplinary approach to brain metastasis from melanoma: the emerging role of systemic therapies. Am Soc Clin Oncol Educ Book. 2013:393-8. DOI: https://doi.org/10.14694/EdBook_AM.2013.33.393
Davies MA, Liu P, McIntyre S, et al. Prognostic factors for survival in melanoma patients with brain metastases. Cancer. 2011;117:1687-96. DOI: https://doi.org/10.1002/cncr.25634
Raizer JJ, Hwu WJ, Panageas KS, et al. Brain and leptomeningeal metastases from cutaneous melanoma: survival outcomes based on clinical features. Neuro Oncol. 2008;10:199-207. DOI: https://doi.org/10.1215/15228517-2007-058
Haydu LE, Lo SN, McQuade JL, et al. Cumulative Incidence and Predictors of CNS Metastasis for Patients With American Joint Committee on Cancer 8th Edition Stage III Melanoma. J Clin Oncol. 2020;38:1429-1441. DOI: https://doi.org/10.1200/JCO.19.01508
McArthur GA, Ribas A. Targeting oncogenic drivers and the immune system in melanoma. J Clin Oncol. 2013;31:499-506. DOI: https://doi.org/10.1200/JCO.2012.45.5568
Ugurel S, Röhmel J, Ascierto PA, et al. Survival of patients with advanced metastatic melanoma: The impact of MAP kinase pathway inhibition and immune checkpoint inhibition - Update 2019. Eur J Cancer. 2020;130:126-138. DOI: https://doi.org/10.1016/j.ejca.2020.02.021
Gampa G, Vaidhyanathan S, Resman BW, Parrish et al. Challenges in the delivery of therapies to melanoma brain metastases. Curr Pharmacol Rep. 2016;2:309-325. DOI: https://doi.org/10.1007/s40495-016-0072-z
Mittapalli RK, Vaidhyanathan S, Sane R, et al. Impact of P-glycoprotein (ABCB1) and breast cancer resistance protein (ABCG2) on the brain distribution of a novel BRAF inhibitor: vemurafenib (PLX4032). J Pharmacol Exp Ther. 2012;342:33-40. DOI: https://doi.org/10.1124/jpet.112.192195
Mittapalli RK, Vaidhyanathan S, Dudek AZ et al. Mechanisms Limiting Distribution of the Threonine-Protein Kinase B-RaFV600E Inhibitor Dabrafenib to the Brain: Implications for the Treatment of Melanoma Brain Metastases. J. of Pharmacol Exp Ther. 2013,344:655-664. DOI: https://doi.org/10.1124/jpet.112.201475
Long GV, Atkinson V, Menzies AM, et al. A randomized phase II study of nivolumab or nivolumab combined with ipilimumab in patients (pts) with melanoma brain metastases (mets): The Anti-PD1 Brain Collaboration (ABC). Journal of Clinical Oncology 2017;35:9508-9508. DOI: https://doi.org/10.1200/JCO.2017.35.15_suppl.9508
Davies MA, Robert C, Long GV, et al. COMBI-MB: A phase II study of combination dabrafenib (D) and trametinib (T) in patients (pts) with BRAF V600–mutant (mut) melanoma brain metastases (MBM). Journal of Clinical Oncology 2017;35:9506-9506. DOI: https://doi.org/10.1200/JCO.2017.35.15_suppl.9506
Dutriaux C, Robert C, Grob JJ, et al. An open-label, non-randomized, phase IIIb study of trametinib in combination with dabrafenib for patients with unresectable advanced BRAFV600-mutant melanoma: a subgroup analysis of patients with brain metastasis. Annals of Oncology 2019;30:v533-v563. DOI: https://doi.org/10.1093/annonc/mdz255.021
Marquez-Rodas I, Arance A, Berciano Guerrero MA, et al. Intracranial activity of encorafenib and binimetinib followed by radiotherapy in patients with BRAF mutated melanoma and brain metastasis: Preliminary results of the GEM1802/EBRAIN-MEL phase II clinical trial. Annals of Oncology 2021;32:S867-S905. DOI: https://doi.org/10.1016/j.annonc.2021.08.1423
Di Giacomo AM, Valente M, Cerase A, et al. Immunotherapy of brain metastases: breaking a "dogma". J Exp Clin Cancer Res. 2019;38:419. DOI: https://doi.org/10.1186/s13046-019-1426-2
Margolin KA, Tawbi HA, Forsyth PA, et al. CheckMate 204: 3-year outcomes of treatment with combination nivolumab (NIVO) plus ipilimumab (IPI) for patients (pts) with active melanoma brain metastases (MBM). Annals of Oncology 2021;32:S867-S905. DOI: https://doi.org/10.1016/j.annonc.2021.08.1424
Tawbi HA, Long GV, Meyer N, et al. Treatment outcomes in patients (pts) with melanoma brain metastases (MBM) treated with systemic therapy: A systematic literature review (SLR) and meta-analysis. Journal of Clinical Oncology 2021;39:9561-9561. DOI: https://doi.org/10.1200/JCO.2021.39.15_suppl.9561
Di Giacomo AM, Chiarion-Sileni V, Del Vecchio M, et al. Primary Analysis and 4-Year Follow-Up of the Phase III NIBIT-M2 Trial in Melanoma Patients With Brain Metastases. Clin Cancer Res. 2021;27:4737-4745. DOI: https://doi.org/10.1158/1078-0432.CCR-21-1046
Lehrer EJ, Peterson J, Brown PD, et al. Treatment of brain metastases with stereotactic radiosurgery and immune checkpoint inhibitors: An international meta-analysis of individual patient data. Radiother Oncol. 2019;130:104-112. DOI: https://doi.org/10.1016/j.radonc.2018.08.025
Burton EM, Amaria RN, Glitza IC, et al. Phase II Study of TRIplet combination Nivolumab (N) with Dabrafenib (D) and Trametinib (T) (TRIDeNT) in patients (pts) with PD-1 naïve or refractory BRAF-mutated metastatic melanoma (MM) with or without active brain metastases. Journal of Clinical Oncology 2021;39:9520-9520. DOI: https://doi.org/10.1200/JCO.2021.39.15_suppl.9520
Supporting Agencies
NoneHow to Cite
The management of brain metastases in melanoma patients. (2022). Working Paper of Public Health, 10(1). https://doi.org/10.4081/wpph.2022.9489
Most read articles by the same author(s)
- Alessandro Croce, Marinella Bertolotti, Stefania Crivellari, Marco Amisano, Elisabetta Nada, Federica Grosso, Laura Cagna, Caterina Rinaudo, Giorgio Gatti, Antonio Maconi, Scanning Electron Microscopy coupled with Energy Dispersive Spectroscopy applied to the analysis of fibers and particles in tissues from colon adenocarcinomas , Working Paper of Public Health: Vol. 11 (2023)
- Iacopo Megna, Serena Penpa, Antonella Cassinari, Christian Leli, Andrea Rocchetti, Annalisa Roveta, Marta Betti, Antonio Maconi, SARS-CoV-2 vs Streptococcus pneumoniae: a comparison of clinical features, laboratory findings, and clinical outcomes in patients hospitalized at Alessandria’s General Hospital , Working Paper of Public Health: Vol. 11 (2023)
- Adriana Canepa, Carlo Degiacomi, Maria Cristina Portinaro, Grazia Gatti, Stefania Crivellari, Carlotta Bertolina, Marianna Farotto, Melissa Pozzi, Leonardo Deambrogio, Riccardo Belvisotti, Marinella Bertolotti, Antonio Maconi, Feasibility of a questionnaire on asbestos awareness among students: a pilot study , Working Paper of Public Health: Vol. 11 (2023)
- Cristina Montarolo, Lara Calcagno, Simona Martinotti, Filippo Erli, Antonio Covelli, Fabiana Vercellino, Elia Ranzato, Iacopo Megna, Multiple sclerosis diagnosis: free light chain testing as a possible valuable marker in cerebrospinal fluid , Working Paper of Public Health: Vol. 13 (2025)
- Annalisa Roveta, Francesca Ugo, Marta Betti, Serena Penpa, Tatiana Bolgeo, Marinella Bertolotti, Carolina Pelazza, Fabio Giacchero, Denise Gatti, Roberta Di Matteo, Costanza Massarino, Stefania Crivellari, Menada Gardalini, Antonio Maconi, Clinical Research Coordinator and Clinical Research Nurse: education and role at the Clinical Trial Center of Alessandria , Working Paper of Public Health: Vol. 9 No. 1 (2021)
- Carlotta Bertolina, Marianna Farotto, Stefania Crivellari, Fabio Giacchero, Chiara Grasso, Marinella Bertolotti, Antonio Maconi, Summary of the 2016 World Health Organization Report and 2021 Compendium on environmental diseases , Working Paper of Public Health: Vol. 11 (2023)
- Pier Luigi Piovano, Federica Grosso, Gianmauro Numico, Antonio Maconi, Biagio Polla, Lung cancer screening: a literature review , Working Paper of Public Health: Vol. 7 (2019)
- Antonio Maconi, Mariateresa Dacquino, Federica Viazzi, Emanuela Bovo, Federica Grosso, Mariasilvia Como, Mesothelioma: one disease, many definitions. Comparative linguistic analysis in a “health literacy” perspective , Working Paper of Public Health: Vol. 8 (2020)
- Antonina De Angelis, Stefania Crivellari, Marinella Bertolotti, Antonella Cassinari, Michela Lia, Antonio Maconi, Federica Grosso, A feasibility esplorative study of a novel modality of using patient reported outcomes for patients with rare cancers and melanoma (prosexplor). , Working Paper of Public Health: Vol. 7 (2019)
- Michela Lia, Stefania Crivellari, Antonina De Angelis, Rosa Laface, Francesca Ugo, Antonio Maconi, Federica Grosso, Asbestos ban: what is the worldwide current situation? , Working Paper of Public Health: Vol. 7 (2019)
