MMOD-08 REAL WORLD TREATMENT PATTERNS AND OUTCOMES FOR PATIENTS WITH MELANOMA BRAIN METASTASIS: A SINGLE CENTER EXPERIENCE Open Access

Traditionally, patients with melanoma brain metastasis (MBM) have poor survival outcomes. We investigated real‐world treatment patterns and outcomes of patients with MBM.

We conducted a retrospective, single-institution analysis of patients with malignant melanoma who received immunotherapy and developed synchronous or metachronous MBM. Real world treatment patterns, therapy sequencing and outcomes were analyzed in detail.

Of 453 patients with melanoma who received immunotherapy at our center, 138 developed brain metastases. Median age was 59 years, 63% were male, and 91% were white. 72% had cutaneous melanoma, 5% had mucosal, 4% had acral, and 19% had other subtypes. BRAF V600 mutation was positive in 36%. 44% had synchronous MBMs (within 30 days of diagnosis of unresectable/metastatic disease), and 56% had metachronous MBMs. 3% had solitary MBMs without concurrent extracranial disease. For patients with metachronous MBMs, median time to CNS metastasis from stage IV diagnosis was 11 months (range, 1 – 211 months). 69% of patients had 1 – 5 MBMs, 20% had 6 – 10 MBMs, and 11% had 11 or more MBMs. For first-line therapy, 66% received stereotactic radiosurgery (SRS) or gamma-knife radiosurgery (GKRS), 14% underwent surgical resection, 12% received whole-brain radiation therapy (WBRT), 88% received systemic therapy (with or without other therapy), and 72% received systemic therapy and loco-regional therapy. Systemic therapies included ipilimumab/nivolumab (36%), nivolumab alone (10%), pemboliaumab alone (20%), ipilimumab alone (23%), BRAF/MEKi (6%), or other (11%). 54% of patients who received treatment and/or were followed with imaging experienced disease progression. Median overall survival (OS) for the entire cohort was 66 months (range, 1 – 407 months).

Most patients with MBM receive a combination of loco-regional interventions and systemic therapy. Real-world outcomes for patients with MBMs have improved with newer treatments.