Amrita Ladwa, Mu-Hsun Chen, Omar Elghawy, Jacob Friedberg, Hong Zhu, Varinder Kaur
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Synchronous MBM (within 30 days of stage IV diagnosis) was associated with improved CNS PFS (HR = 0.65, 95% CI [0.43-0.99]; <i>p</i> = 0.046). Median OS was 22.3 months from development of MBM and 35.0 months from date of first-line therapy for advanced melanoma. All patients received ICI and most (60.1%) developed any grade irAE. Patients who received combination ICI had higher rates of irAE than patients who received single-agent ICI (χ<sup>2</sup> = 16.31, <i>p</i> < 0.001). Development of irAE was associated with improved median OS (45.0 months vs 21.7 months, HR = 0.50, 95% CI [0.30-0.83]; <i>p</i> = 0.008).</p><p><strong>Conclusion: </strong>Incidence of irAE was associated with improved survival and trended toward improved CNS PFS.</p>","PeriodicalId":13328,"journal":{"name":"Immunotherapy","volume":" ","pages":"801-809"},"PeriodicalIF":2.3000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427501/pdf/","citationCount":"0","resultStr":"{\"title\":\"Treatment patterns and outcomes in melanoma brain metastasis: exploring immune-related adverse events and survival.\",\"authors\":\"Amrita Ladwa, Mu-Hsun Chen, Omar Elghawy, Jacob Friedberg, Hong Zhu, Varinder Kaur\",\"doi\":\"10.1080/1750743X.2025.2548753\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To investigate real-world treatment patterns, incidence of immune-related adverse events (irAE), and impact of irAEs on outcomes in MBM.</p><p><strong>Methods: </strong>We performed a retrospective study on MBM patients treated with immunotherapy in 2011-2022.</p><p><strong>Results: </strong>Of the 1979 patients treated with immunotherapy, 453 had melanoma and 138 developed MBM. Median time from melanoma diagnosis to CNS metastasis was 37.8 months and median CNS PFS was 11.1 months. Higher burden of MBMs (6-10 or 11+) was associated with worse CNS PFS compared with low MBM burden (1-5 lesions) (HR = 1.89, 95% CI [1.10-3.25]; <i>p</i> = 0.022), (HR = 1.92, 95% CI [1.02-3.63]; <i>p</i> = 0.044). Synchronous MBM (within 30 days of stage IV diagnosis) was associated with improved CNS PFS (HR = 0.65, 95% CI [0.43-0.99]; <i>p</i> = 0.046). Median OS was 22.3 months from development of MBM and 35.0 months from date of first-line therapy for advanced melanoma. All patients received ICI and most (60.1%) developed any grade irAE. Patients who received combination ICI had higher rates of irAE than patients who received single-agent ICI (χ<sup>2</sup> = 16.31, <i>p</i> < 0.001). 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引用次数: 0
摘要
目的：研究现实世界的治疗模式，免疫相关不良事件（irAE）的发生率，以及irAE对MBM预后的影响。方法：我们对2011-2022年接受免疫治疗的MBM患者进行回顾性研究。结果：在接受免疫治疗的1979例患者中，453例发生黑色素瘤，138例发生MBM。从黑色素瘤诊断到中枢神经系统转移的中位时间为37.8个月，中位中枢神经系统PFS为11.1个月。与低MBM负担（1-5个病灶）相比，较高的MBM负担（6-10或11+）与较差的CNS PFS相关（HR = 1.89, 95% CI [1.10-3.25]; p = 0.022）， （HR = 1.92, 95% CI [1.02-3.63]; p = 0.044）。同步MBM （IV期诊断30天内）与CNS PFS改善相关（HR = 0.65, 95% CI [0.43-0.99]; p = 0.046）。从MBM发展到中位OS为22.3个月，从一线治疗晚期黑色素瘤之日起为35.0个月。所有患者均接受了ICI治疗，大多数（60.1%）发生了不同级别的irAE。联合ICI组的irAE发生率高于单药ICI组（χ2 = 16.31, p p = 0.008）。结论：irAE的发生率与生存改善相关，并趋向于改善中枢神经系统PFS。
Treatment patterns and outcomes in melanoma brain metastasis: exploring immune-related adverse events and survival.
Purpose: To investigate real-world treatment patterns, incidence of immune-related adverse events (irAE), and impact of irAEs on outcomes in MBM.
Methods: We performed a retrospective study on MBM patients treated with immunotherapy in 2011-2022.
Results: Of the 1979 patients treated with immunotherapy, 453 had melanoma and 138 developed MBM. Median time from melanoma diagnosis to CNS metastasis was 37.8 months and median CNS PFS was 11.1 months. Higher burden of MBMs (6-10 or 11+) was associated with worse CNS PFS compared with low MBM burden (1-5 lesions) (HR = 1.89, 95% CI [1.10-3.25]; p = 0.022), (HR = 1.92, 95% CI [1.02-3.63]; p = 0.044). Synchronous MBM (within 30 days of stage IV diagnosis) was associated with improved CNS PFS (HR = 0.65, 95% CI [0.43-0.99]; p = 0.046). Median OS was 22.3 months from development of MBM and 35.0 months from date of first-line therapy for advanced melanoma. All patients received ICI and most (60.1%) developed any grade irAE. Patients who received combination ICI had higher rates of irAE than patients who received single-agent ICI (χ2 = 16.31, p < 0.001). Development of irAE was associated with improved median OS (45.0 months vs 21.7 months, HR = 0.50, 95% CI [0.30-0.83]; p = 0.008).
Conclusion: Incidence of irAE was associated with improved survival and trended toward improved CNS PFS.
期刊介绍：
Many aspects of the immune system and mechanisms of immunomodulatory therapies remain to be elucidated in order to exploit fully the emerging opportunities. Those involved in the research and clinical applications of immunotherapy are challenged by the huge and intricate volumes of knowledge arising from this fast-evolving field. The journal Immunotherapy offers the scientific community an interdisciplinary forum, providing them with information on the most recent advances of various aspects of immunotherapies, in a concise format to aid navigation of this complex field.
Immunotherapy delivers essential information in concise, at-a-glance article formats. Key advances in the field are reported and analyzed by international experts, providing an authoritative but accessible forum for this vitally important area of research. Unsolicited article proposals are welcomed and authors are required to comply fully with the journal''s Disclosure & Conflict of Interest Policy as well as major publishing guidelines, including ICMJE and GPP3.
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