Melanoma Brain Metastases: A Retrospective Analysis of Prognostic Factors and Efficacy of Multimodal Therapies.

Autor: Internò V; Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70121 Bari, Italy.; Medical Oncology Unit, Azienda Ospedaliero-Universitaria, Policlinico di Bari, 70124 Bari, Italy., Sergi MC; Medical Oncology Unit, Azienda Ospedaliero-Universitaria, Policlinico di Bari, 70124 Bari, Italy., Metta ME; Medical Statistic and Biometry Unit, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, 70121 Bari, Italy., Guida M; IRCCS, Istituto Tumori Giovanni Paolo II, 70124 Bari, Italy., Trerotoli P; Medical Statistic and Biometry Unit, Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy., Strippoli S; IRCCS, Istituto Tumori Giovanni Paolo II, 70124 Bari, Italy., Circelli S; Medical Oncology Unit, Azienda Ospedaliero-Universitaria, Policlinico di Bari, 70124 Bari, Italy., Porta C; Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70121 Bari, Italy.; Medical Oncology Unit, Azienda Ospedaliero-Universitaria, Policlinico di Bari, 70124 Bari, Italy., Tucci M; Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70121 Bari, Italy.; Medical Oncology Unit, Azienda Ospedaliero-Universitaria, Policlinico di Bari, 70124 Bari, Italy.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2023 Feb 28; Vol. 15 (5). Date of Electronic Publication: 2023 Feb 28.
DOI: 10.3390/cancers15051542
Abstrakt: Brain metastasis in cutaneous melanoma (CM) has historically been considered to be a dismal prognostic feature, although recent evidence has highlighted the intracranial activity of combined immunotherapy (IT). Herein, we completed a retrospective study to investigate the impact of clinical-pathological features and multimodal therapies on the overall survival (OS) of CM patients with brain metastases. A total of 105 patients were evaluated. Nearly half of the patients developed neurological symptoms leading to a negative prognosis ( p = 0.0374). Both symptomatic and asymptomatic patients benefited from encephalic radiotherapy (eRT) ( p = 0.0234 and p = 0.011). Lactate dehydrogenase (LDH) levels two times higher than the upper limit normal (ULN) at the time of brain metastasis onset was associated with poor prognosis ( p = 0.0452) and identified those patients who did not benefit from eRT. Additionally, the poor prognostic role of LDH levels was confirmed in patients treated with targeted therapy (TT) ( p = 0.0015) concerning those who received immunotherapy (IT) ( p = 0.16). Based on these results, LDH levels higher than two times the ULN at the time of the encephalic progression identify those patients with a poor prognosis who did not benefit from eRT. The negative prognostic role of LDH levels on eRT observed in our study will require prospective evaluations.
Databáze: MEDLINE
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