Abstract
Up to 40% of patients with metastatic melanoma (MM) develop brain metastases. Radiotherapy (RT) may potentiate the effects of immunotherapy (IO), even on distant sites (abscopal effect). Material and Methods: We retrospectively analyzed all our MM patients treated with IO within 6 months before/after brain RT between 2012 and 2016. Progression-free (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method and compared with those of controls treated with IO during the same period. Results: Thirty-six cases and 25 controls were identified. Among cases, 23 patients received an anti-CTLA4 agent and 13 an anti-PD1 agent. Eighteen cases were treated with stereotactic RT and 18 with whole-brain RT. Median PFS from the beginning of RT was 4 months in first-line and 2 months in second-line treatment. A third of the cases progressed at first evaluation after RT. Median OS from the beginning of RT was 7 months in first-line and 4 months in second-line treatment. Median PFS and OS of each treatment line showed a trend towards inferiority compared with those of controls. Conclusion: Synergism between RT and IO was not observed in our case series. No cases of abscopal effect were seen, and most patients underwent early systemic progression after RT.
| Original language | English |
|---|---|
| Pages (from-to) | 182-188 |
| Number of pages | 7 |
| Journal | Oncology Research and Treatment |
| Volume | 42 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 1 2019 |
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Keywords
- Brain
- Immunotherapy
- Melanoma
- Metastasis
- Radiotherapy
ASJC Scopus subject areas
- Hematology
- Oncology
- Cancer Research
Cite this
Combination of Immunotherapy and Brain Radiotherapy in Metastatic Melanoma : A Retrospective Analysis. / Galli, Giulia; Cavalieri, Stefano; Di Guardo, Lorenza; Cimminiello, Carolina; Nichetti, Federico; Corti, Francesca; Garcia, Monica Alicia; Pappalardi, Brigida; Fallai, Carlo; De Braud, Filippo; Platania, Marco; Del Vecchio, Michele.
In: Oncology Research and Treatment, Vol. 42, No. 4, 01.04.2019, p. 182-188.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Combination of Immunotherapy and Brain Radiotherapy in Metastatic Melanoma
T2 - A Retrospective Analysis
AU - Galli, Giulia
AU - Cavalieri, Stefano
AU - Di Guardo, Lorenza
AU - Cimminiello, Carolina
AU - Nichetti, Federico
AU - Corti, Francesca
AU - Garcia, Monica Alicia
AU - Pappalardi, Brigida
AU - Fallai, Carlo
AU - De Braud, Filippo
AU - Platania, Marco
AU - Del Vecchio, Michele
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Up to 40% of patients with metastatic melanoma (MM) develop brain metastases. Radiotherapy (RT) may potentiate the effects of immunotherapy (IO), even on distant sites (abscopal effect). Material and Methods: We retrospectively analyzed all our MM patients treated with IO within 6 months before/after brain RT between 2012 and 2016. Progression-free (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method and compared with those of controls treated with IO during the same period. Results: Thirty-six cases and 25 controls were identified. Among cases, 23 patients received an anti-CTLA4 agent and 13 an anti-PD1 agent. Eighteen cases were treated with stereotactic RT and 18 with whole-brain RT. Median PFS from the beginning of RT was 4 months in first-line and 2 months in second-line treatment. A third of the cases progressed at first evaluation after RT. Median OS from the beginning of RT was 7 months in first-line and 4 months in second-line treatment. Median PFS and OS of each treatment line showed a trend towards inferiority compared with those of controls. Conclusion: Synergism between RT and IO was not observed in our case series. No cases of abscopal effect were seen, and most patients underwent early systemic progression after RT.
AB - Up to 40% of patients with metastatic melanoma (MM) develop brain metastases. Radiotherapy (RT) may potentiate the effects of immunotherapy (IO), even on distant sites (abscopal effect). Material and Methods: We retrospectively analyzed all our MM patients treated with IO within 6 months before/after brain RT between 2012 and 2016. Progression-free (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method and compared with those of controls treated with IO during the same period. Results: Thirty-six cases and 25 controls were identified. Among cases, 23 patients received an anti-CTLA4 agent and 13 an anti-PD1 agent. Eighteen cases were treated with stereotactic RT and 18 with whole-brain RT. Median PFS from the beginning of RT was 4 months in first-line and 2 months in second-line treatment. A third of the cases progressed at first evaluation after RT. Median OS from the beginning of RT was 7 months in first-line and 4 months in second-line treatment. Median PFS and OS of each treatment line showed a trend towards inferiority compared with those of controls. Conclusion: Synergism between RT and IO was not observed in our case series. No cases of abscopal effect were seen, and most patients underwent early systemic progression after RT.
KW - Brain
KW - Immunotherapy
KW - Melanoma
KW - Metastasis
KW - Radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=85062669072&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062669072&partnerID=8YFLogxK
U2 - 10.1159/000497211
DO - 10.1159/000497211
M3 - Article
C2 - 30836373
AN - SCOPUS:85062669072
VL - 42
SP - 182
EP - 188
JO - Oncology Research and Treatment
JF - Oncology Research and Treatment
SN - 2296-5270
IS - 4
ER -