Current Treatment Approaches and Global Consensus Guidelines for Brain Metastases in Melanoma

Xiang Lin Tan; Amy Le; Fred C. Lam; Emilie Scherrer; Robert G. Kerr; Anthony C. Lau; Jiali Han; Ruixuan Jiang; Scott J. Diede; Irene M. Shui

doi:10.3389/fonc.2022.885472

Current Treatment Approaches and Global Consensus Guidelines for Brain Metastases in Melanoma

Xiang Lin Tan, Amy Le, Fred C. Lam, Emilie Scherrer, Robert G. Kerr, Anthony C. Lau, Jiali Han, Ruixuan Jiang, Scott J. Diede, Irene M. Shui

Research output: Contribution to journal › Review article › peer-review

15 Scopus citations

Abstract

Background: Up to 60% of melanoma patients develop melanoma brain metastases (MBM), which traditionally have a poor diagnosis. Current treatment strategies include immunotherapies (IO), targeted therapies (TT), and stereotactic radiosurgery (SRS), but there is considerable heterogeneity across worldwide consensus guidelines. Objective: To summarize current treatments and compare worldwide guidelines for the treatment of MBM. Methods: Review of global consensus treatment guidelines for MBM patients. Results: Substantial evidence supported that concurrent IO or TT plus SRS improves progression-free survival (PFS) and overall survival (OS). Guidelines are inconsistent with regards to recommendations for surgical resection of MBM, since surgical resection of symptomatic lesions alleviates neurological symptoms but does not improve OS. Whole-brain radiation therapy is not recommended by all guidelines due to negative effects on neurocognition but can be offered in rare palliative scenarios. Conclusion: Worldwide consensus guidelines consistently recommend up-front combination IO or TT with or without SRS for the treatment of MBM.

Original language	English (US)
Article number	885472
Journal	Frontiers in Oncology
Volume	12
DOIs	https://doi.org/10.3389/fonc.2022.885472
State	Published - May 5 2022
Externally published	Yes

Keywords

brain metastasis
immunotherapy
melanoma
targeted therapy
treatment guidelines

ASJC Scopus subject areas

Oncology
Cancer Research

Access to Document

10.3389/fonc.2022.885472

Cite this

@article{20929e514a5445c8a3c2b81ded9252f1,

title = "Current Treatment Approaches and Global Consensus Guidelines for Brain Metastases in Melanoma",

abstract = "Background: Up to 60% of melanoma patients develop melanoma brain metastases (MBM), which traditionally have a poor diagnosis. Current treatment strategies include immunotherapies (IO), targeted therapies (TT), and stereotactic radiosurgery (SRS), but there is considerable heterogeneity across worldwide consensus guidelines. Objective: To summarize current treatments and compare worldwide guidelines for the treatment of MBM. Methods: Review of global consensus treatment guidelines for MBM patients. Results: Substantial evidence supported that concurrent IO or TT plus SRS improves progression-free survival (PFS) and overall survival (OS). Guidelines are inconsistent with regards to recommendations for surgical resection of MBM, since surgical resection of symptomatic lesions alleviates neurological symptoms but does not improve OS. Whole-brain radiation therapy is not recommended by all guidelines due to negative effects on neurocognition but can be offered in rare palliative scenarios. Conclusion: Worldwide consensus guidelines consistently recommend up-front combination IO or TT with or without SRS for the treatment of MBM.",

keywords = "brain metastasis, immunotherapy, melanoma, targeted therapy, treatment guidelines",

author = "Tan, {Xiang Lin} and Amy Le and Lam, {Fred C.} and Emilie Scherrer and Kerr, {Robert G.} and Lau, {Anthony C.} and Jiali Han and Ruixuan Jiang and Diede, {Scott J.} and Shui, {Irene M.}",

note = "Publisher Copyright: Copyright {\textcopyright} 2022 Tan, Le, Lam, Scherrer, Kerr, Lau, Han, Jiang, Diede and Shui.",

year = "2022",

month = may,

day = "5",

doi = "10.3389/fonc.2022.885472",

language = "English (US)",

volume = "12",

journal = "Frontiers in Oncology",

issn = "2234-943X",

publisher = "Frontiers Media SA",

}

TY - JOUR

T1 - Current Treatment Approaches and Global Consensus Guidelines for Brain Metastases in Melanoma

AU - Tan, Xiang Lin

AU - Le, Amy

AU - Lam, Fred C.

AU - Scherrer, Emilie

AU - Kerr, Robert G.

AU - Lau, Anthony C.

AU - Han, Jiali

AU - Jiang, Ruixuan

AU - Diede, Scott J.

AU - Shui, Irene M.

PY - 2022/5/5

Y1 - 2022/5/5

N2 - Background: Up to 60% of melanoma patients develop melanoma brain metastases (MBM), which traditionally have a poor diagnosis. Current treatment strategies include immunotherapies (IO), targeted therapies (TT), and stereotactic radiosurgery (SRS), but there is considerable heterogeneity across worldwide consensus guidelines. Objective: To summarize current treatments and compare worldwide guidelines for the treatment of MBM. Methods: Review of global consensus treatment guidelines for MBM patients. Results: Substantial evidence supported that concurrent IO or TT plus SRS improves progression-free survival (PFS) and overall survival (OS). Guidelines are inconsistent with regards to recommendations for surgical resection of MBM, since surgical resection of symptomatic lesions alleviates neurological symptoms but does not improve OS. Whole-brain radiation therapy is not recommended by all guidelines due to negative effects on neurocognition but can be offered in rare palliative scenarios. Conclusion: Worldwide consensus guidelines consistently recommend up-front combination IO or TT with or without SRS for the treatment of MBM.

AB - Background: Up to 60% of melanoma patients develop melanoma brain metastases (MBM), which traditionally have a poor diagnosis. Current treatment strategies include immunotherapies (IO), targeted therapies (TT), and stereotactic radiosurgery (SRS), but there is considerable heterogeneity across worldwide consensus guidelines. Objective: To summarize current treatments and compare worldwide guidelines for the treatment of MBM. Methods: Review of global consensus treatment guidelines for MBM patients. Results: Substantial evidence supported that concurrent IO or TT plus SRS improves progression-free survival (PFS) and overall survival (OS). Guidelines are inconsistent with regards to recommendations for surgical resection of MBM, since surgical resection of symptomatic lesions alleviates neurological symptoms but does not improve OS. Whole-brain radiation therapy is not recommended by all guidelines due to negative effects on neurocognition but can be offered in rare palliative scenarios. Conclusion: Worldwide consensus guidelines consistently recommend up-front combination IO or TT with or without SRS for the treatment of MBM.

KW - brain metastasis

KW - immunotherapy

KW - melanoma

KW - targeted therapy

KW - treatment guidelines

UR - http://www.scopus.com/inward/record.url?scp=85130596972&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85130596972&partnerID=8YFLogxK

U2 - 10.3389/fonc.2022.885472

DO - 10.3389/fonc.2022.885472

M3 - Review article

AN - SCOPUS:85130596972

SN - 2234-943X

VL - 12

JO - Frontiers in Oncology

JF - Frontiers in Oncology

M1 - 885472

ER -

Current Treatment Approaches and Global Consensus Guidelines for Brain Metastases in Melanoma

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this