Radiation necrosis of the brain in melanoma patients successfully treated with ipilimumab, three case studies.
Metastasis to the brain is a frequent event in patients with advanced melanoma. Despite treatment with neurosurgery, pancranial irradiation and high-precision conformal radiotherapy, the prognosis of patients suffering from melanoma brain metastasis has remained very poor. Ipilimumab is a new effective immunotherapy for the treatment of advanced melanoma and has demonstrated activity against brain metastases. We report three patients successfully treated with ipilimumab who subsequently developed focal necrosis of the brain following prior radiotherapy of their melanoma brain metastases. As new active systemic treatment options become available that improve the survival of patients with melanoma brain metastases, adequate diagnosis and management of the late sequela from radiation to the brain is likely to gain importance in the management of these patients.
Department of Medical Oncology, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium. Stephanie.Du.Four@vub.ac.be
Stephanie
S
Du Four
Sofie
S
Wilgenhof
Johnny
J
Duerinck
Alex
A
Michotte
Anne
A
Van Binst
Mark
M
De Ridder
Bart
B
Neyns
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001706:Biopsy; D001932:Brain Neoplasms / Q000276:immunology / Q000532:radiotherapy / Q000556:secondary* / Q000628:therapy*; D016371:Cranial Irradiation; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D000074324:Ipilimumab; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000276:immunology / Q000532:radiotherapy / Q000556:secondary* / Q000628:therapy*; D008875:Middle Aged; D009336:Necrosis; D012878:Skin Neoplasms / Q000473:pathology*; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D000074324:Ipilimumab