Selected studies assessing the efficacy and toxicity of SRS and immunotherapy for the treatment of melanoma brain metastases
| Authors | Patients (n) | Treatment | Median survival (months) | Brain control | Neurotoxicity | Brain necrosis (% of patients) |
|---|---|---|---|---|---|---|
| Knisely et al., 2012 [22] | 16 | Ipi after SRS | 21.3 | NR | NR | NR |
| 11 | Ipi before SRS | 19.8 | NR | NR | NR | |
| 50 | SRS alone | 4.9 | NR | NR | NR | |
| Kiess et al., 2015 [23] | 15 | Concurrent SRS and Ipi (within 1 month) | 1-year 65% | 1-year LC 100% | Grade 2, 33% Grade 3, 26% | Early and late RN 50% of patients treated during or before Ipi and 13% of patients treated after Ipi. |
| 19 | Nonconcurrent, SRS before Ipi (median 3 months) | 1-year 56% | 1-year LC 87% | Grade 2, 10% Grade 3, 6% Grade 4, 3% | ||
| 12 | Nonconcurrent, SRS after Ipi (median 2 months) | 1-year 40% | 1-year LC 89% | |||
| Ahmed et al., 2016 [24] | 26 | SRS/SRT and Nivo | 78% (1-year 55%) | 6-month and 1-year DBC 61 and 38% 6-month and 1-year LC 89 and 82% | Grade 2, 37% | 27% |
| Qian et al., 2016 [25] | 33 | SRS and concurrent IPI (1) or Pembro (14) | 19.1 | NR | NR | NR |
| 42 | Nonconcurrent SRS and Ipi (35) or Pembro (7) | 9 | NR | NR | NR | |
| Choong et al., 2017 [26] | 28 | Concurrent SRS and Ipi (within 6 weeks) | 7.5 (1-year 40%) | 7.5 months | NR | 0% |
| 11 | Concurrent SRS and Nivo (within 6 weeks) | 20.4 (1-year 78%) | 12.7 months | NR | 18% | |
| Cohen-Inbar et al., 2017 [27] | 32 | Ipi before or during SRS | 1-year 59.4% | 1-year LC and DBF 54.4 and 15.8% | NR | 31% |
| 14 | Ipi after SRS | 1-year 33% | 1-year LC and DBF 16.5 and 26.8% | NR | 7% | |
| Gaudi-Marqueste et al., 2017 [28] | 21 | SRS before Ipi (21), Nivo (17), both (6) | Ipi, 8.6 (1-year 41.2%) Nivo,12 (1-year 63%) | NR | NR | NR |
| Patel et al., 2017 [29] | 20 | Ipi plus SRS (whitin 4 months) | 8 (1-year 37.1%) | 1-year LC and DBF 71 and 12% | NR | 18% at 1 year |
| Skrepnik et al., 2017 [30] | 25 | Ipi before or concurrent (within 1 month) | 35 (1-year and 2-year 83 and 64%) | 16.7 (1-year and 2-year 52 and 34.8%) | NR | 20.7 5% symptomatic |
| Chen et al., 2018 [31] | 23 (28)° | concurrent SRS-SRT and Ipi or Pembro | 24.7 (1-year 75%) | 1-year LC 88% | Grade 2, 42% Grade 3, 0% | 27% of 22 metastases confirmed by histology |
| 12 (51)° | Nonconcurrent SRS-SRT and Ipi or Pembro | 14.5 (1-year 53%) | 1-year LC 79% | Grade 2, 35% Grade 3, 33% | ||
| Nardin et al., 2018 [32] | 25 | SRS and Pembro | 15.3 | 8.4 (6-months LC 80%) | NR | 6.8% |
| Current series | 45 | concurrent SRS-SRT and Nivo (within 1 week) | 22 (1-year 78%) | 1-year 42% 1-year LC and DBC 85 and 46% | Grade 3, 11% | 25% at 1-year |
| 35 | Concurrent SRS-SRT and Ipi (within 1 week) | 14.7 (1-year 68%) | 1-year 17% 1-year LC and DBC 70 and 20% | Grade 3, 6% | 17% at 1 year |
Ipi Ipilimumab, Nivo Nivolumab, Pembro Pembrolizumab, SRS Stereotactic radiosurgery, SRT Stereotactic radiotherapy, LC local control, DBC distant brain control, NR not reported; ° Study including patients with brain metastases from melanoma, non small-cell lung cancer, and renal cell carcinoma