Systemic Therapies for Melanoma Brain Metastases: A Primer for Radiologists

Abstract

Objective The purpose of this article is to provide a primer for radiologists outlining the modern systemic therapies used in melanoma brain metastases, including tyrosine kinase inhibitors and immune checkpoint inhibitors. The role of radiologic treatment response evaluation will be discussed from the standpoint of both modern systemic therapies and more traditional treatments. Conclusion Understanding the role of systemic treatments in melanoma brain metastases is critical for oncologic imaging interpretation in this unique patient population.

Systematic literature review and meta-analysis of clinical outcomes and prognostic factors for melanoma brain metastases

“…The median overall survival (OS) of patients with melanoma brain metastases (MBM) has historically been approximately 4 months after diagnosis. Recent studies have shown that immune checkpoint inhibitors targeting the programmed cell death protein 1 (PD1) and cytotoxic Tlymphocyte associated protein 4 (CTLA-4) pathways as well as novel small-molecule tyrosine kinase inhibitors targeting BRAF driver mutations, can improve survival in MBM (2). Margolin et al reported a phase II trial investigating the activity of ipilimumab in MBM patients and showed that it was safe and resulted in tumor regression in some patients (3).…”