Impact of immunotherapy on outcomes of cutaneous melanoma and concurrent brain metastasis: a surveillance, epidemiology, and end results analysis of 2010–2020

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2026-02-01 Epub Date: 2025-12-05 DOI:10.1016/j.jocn.2025.111781

James Kelbert , Tara Ghalambor , Kennedy Sparling , Kristin Nosova , Joseph Georges , Robert W Bina

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引用次数: 0

Abstract

Introduction

Melanoma has the greatest incidence of brain metastases among all cancers and once patients develop melanoma brain metastases (MBM) it is the primary contributor to patient mortality. Following the FDA approval of immune checkpoint inhibitors in 2011, there has been a significant reduction in melanoma patient mortality. Therefore, we investigated the impact of immunotherapy on overall survival (OS) pre and post implementation of immunotherapy in the management of MBM.

Methods

Data from patients with MBM upon diagnosis and seen between 2010–2012 and 2018–2020 were collected from Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier survival curves, cox regression models, and log rank tests were conducted using case-listing survival data from Seer*Stat 4.8.2.

Results

There were a total of 1426 patients with MBM at diagnosis: 403 patients (304 men and 99 women) from 2010 to 2012 and 1023 patients (715 men and 308 women) from 2018 to 2020. Median OS for patients from the 2010–2012 and 2018–2020 group was 4 months (95 % CIs: 4–5 month) and 14 months (95 % CIs: 12–19 months), respectively. Patients from 2010 to 2012 had a significantly worse (p = 1e−06) 5-year OS of 9.7 % (95 % CIs: 7.2–13.0 %) compared with 33.4 % (95 % CIs: 29.9–37.3 %) in 2018–2020. When stratified by sex, median OS in men was statistically worse compared to women in the 2010–2012 time period, (HR 2.11, p < 2.2e−16), but demonstrated virtually no difference in 2018 to 2020 (HR 1.02, p = 0.63).

Conclusion

The introduction of immunotherapy with checkpoint inhibitors significantly improved OS among patients with MBM and may have helped mitigate historical disparities in survival between men and women.

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免疫治疗对皮肤黑色素瘤和并发脑转移预后的影响：2010-2020年的监测、流行病学和最终结果分析

在所有癌症中，黑色素瘤的脑转移发生率最高，一旦患者发生黑色素瘤脑转移（MBM），它是导致患者死亡的主要原因。自2011年FDA批准免疫检查点抑制剂以来，黑色素瘤患者死亡率显著降低。因此，我们研究了免疫治疗对MBM治疗前后总生存期（OS）的影响。方法从监测、流行病学和最终结果（SEER）数据库中收集2010-2012年和2018-2020年诊断为MBM的患者的数据。Kaplan-Meier生存曲线、cox回归模型和log rank检验采用Seer*Stat 4.8.2的病例清单生存数据。结果诊断为MBM的患者共1426例，2010 - 2012年为403例（男性304例，女性99例），2018 - 2020年为1023例（男性715例，女性308例）。2010-2012年和2018-2020年组患者的中位OS分别为4个月（95% ci: 4 - 5个月）和14个月（95% ci: 12-19个月）。2010 - 2012年患者的5年OS为9.7% (95% ci: 7.2 - 13.0%)，显著低于2018-2020年的33.4% (95% ci: 29.9 - 37.3%) （p = 1e−06）。当按性别分层时，在2010-2012年期间，男性的中位OS在统计学上比女性差（HR 2.11, p < 2.2e−16），但在2018年至2020年期间几乎没有差异（HR 1.02, p = 0.63）。结论引入免疫治疗检查点抑制剂可显著改善MBM患者的OS，并可能有助于缓解男女生存率的历史差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.