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

Autor: 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
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Frontiers in Oncology, Vol 12 (2022)
Druh dokumentu: article
ISSN: 2234-943X
DOI: 10.3389/fonc.2022.885472
Popis: BackgroundUp 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.ObjectiveTo summarize current treatments and compare worldwide guidelines for the treatment of MBM.MethodsReview of global consensus treatment guidelines for MBM patients.ResultsSubstantial 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.ConclusionWorldwide consensus guidelines consistently recommend up-front combination IO or TT with or without SRS for the treatment of MBM.
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