Survival estimation of melanoma patients with brain metastasis using the Melanoma-molGPA score: external validation from a French cohort

Abstract

While immunotherapies and targeted therapies such as BRAF inhibitors have improved the prognosis, BM is still associated with poor outcome and a short survival. Metastatic melanoma patients are a heterogeneous subgroup with variable prognosis. As several prospective clinical trials have addressed the question of optimal therapy for these patients, an accurate validated selection tool is needed. Melanoma molecular graded prognostic assessment (Melanoma-molGPA) is a new prognostic score for BM melanoma patients. We decided to perform an external validation of this score. All consecutive patients treated between May 2014 and December 2017 for a newly diagnosed locally advanced or metastatic melanoma with available status for BRAF mutation were identified. Melanoma mol-GPA was applied in each patient with BM and correlated to overall survival. One hundred patients were included. Median follow-up was 27.8 months. Distribution for the Melanoma-molGPA groups GPA 0–1, GPA 1.5–2, GPA 2.5–3 and GPA 3.5–4 were as follows: 23, 51, 24 and 2.0%, respectively. Subgroups GPA 2.5–3 and 3.5–4 were combined. Median overall survival for groups GPA 0–1, 1.5–2 and 2.5–4.0 was 4.2, 6.9 and 18.4 months, respectively, P = 0.0032. Our study is the most recent, and with the largest cohort, to validate the Melanoma-molGPA score as an accurate and reproducible score for estimating overall survival. As several prospective clinical trials are addressing the issue of optimal therapy including the impact of local treatment for these patients, the Melanoma-molGPA is a useful tool in BM melanoma patients.

Intracranial Treatment in Melanoma Patients with Brain Metastasis Is Associated with Improved Survival in the Era of Immunotherapy and Anti-BRAF Therapy

“…This makes it difficult to extrapolate results from prospective trials in relation to highly selected patients and strengthens the need of additional local treatment strategies to improve intracranial control even in the era of recent effective systemic treatment. In our study, using prognostic factors from the melanoma-molGPA score, we found comparable survival rates to those previously reported by Sperduto et al, and patients were well balanced according to melanoma molGPA criteria whether they received LT or not [15,20]. So far LT has not been used to define the criteria of the MolGPA score.…”

“…As part of an institutional board-approved study, all consecutive patients treated at the Institut Universitaire du Cancer and CHU de Toulouse, France between May 2014 and December 2017 for newly diagnosed, locally advanced or metastatic melanoma with available tumour status for BRAF mutation were identified by the treatments' database which excluded patients who did not received systemic treatment. Data on demographics, clinical pathology and molecular analyses, including prognostic factors according to the updated melanoma-molGPA score [15,20] were retrospectively extracted from prospectively collected medical records.…”

The Analysis of Trends in Survival for Patients with Melanoma Brain Metastases with Introduction of Novel Therapeutic Options before the Era of Combined Immunotherapy—Multicenter Italian–Polish Report

“…Various factors influencing patients’ prognosis should be considered before making therapeutic decisions in patients with MBM. The prognosis of patients with brain metastases can be estimated and depends on many factors [ 1 , 5 , 6 , 7 , 8 , 9 ]. Among them are histology and molecular profile of a tumor.…”