Melanoma brain metastases (MBMs) are common, with median overall survival for patients with 1-3 MBMs at around 6 months. Drug treatment for MBMs has changed dramatically over the past 10 years, improving overall survival for these patients. Single agent and/or combination targeted therapy and immunotherapy are now used in selected patients with MBMs.
This case series will evaluate changes in adjuvant systemic therapy over 10 years for 100 patients diagnosed with 1-3 MBMs who were initially treated with surgery and/or stereotactic radiation (SRS) (+/-whole brain radiotherapy). The treatment trends and side effects of adjuvant systemic therapy, comparing drugs types used over time, will be analysed and reported.
A total of 100 patients with Stage IV melanoma with 1-3 MBMs were included in this case series and explored. All patients were randomised to WBRTMel RCT between April 2007 and December 2012. Survival time was defined as time from randomisation to death or until last date of contact for survivors. Drug therapy was recorded for the duration of trial follow up.
At January 2017, all patients had died (95%) or were lost to follow up (5%). The median age was 60.3 years (range 26.8-83.9) and 70% of patients were male. Patients were recruited from 14 sites internationally, from Australia (n=68), Norway (n=29) and the UK (n=3). During follow up, 55 patients received concurrent treatment including chemotherapy (n=30), immunotherapy (n=1), targeted therapy (n=9) or multiple therapies (n=15). Data will be presented on treatment patterns and related toxicities.
This case series describes how patterns of treatment with adjuvant systemic therapy for patients with 1-3 MBMs have changed over the past 10 years. This will be important in analysing the effect of therapies other than radiotherapy in MBM control when the trial is due for analysis in late 2018.