State of the art in melanoma brain metastatic treatment and evidence of combined high-dose radiotherapy and immunotherapy approach

Abstract

Finding the perfect strategy to treat melanoma brain metastases (BMs) has become a real-world challenge. Despite the difference in response and survival from different primary tumors, multiple guidelines recommend a multidisciplinary approach to treating BM. Although these guidelines are not specific for melanoma BM, most subjects included in the studies on which the guidelines are based are patients with melanoma. One of the strategies for the treatment of melanoma BM that arouses the most interest is the concurrent use of stereotactic radiosurgery and immunotherapy. This strategy seems to be feasible and has shown to improve survival and local control in retrospective series and phase 1 and 2 prospective trials. Here, we present a review of the current recommendations for addressing melanoma BM and the evidence available about the strategy combining focal radiation and immune checkpoint inhibitors.