title: Evolving treatment options for melanoma brain metastases.
abstract: Melanoma is a leading cause of lost productivity due to premature cancer mortality. Melanoma frequently spreads to the brain and is associated with rapid deterioration in quality and quantity of life. Until now, treatment options have been restricted to surgery and radiotherapy, although neither modality has been well studied in clinical trials. However, the new immune checkpoint inhibitors and molecularly targeted agents that have been introduced for treatment of metastatic melanoma are active against brain metastases and offer new opportunities to improve disease outcomes. New challenges arise, including how to integrate or sequence multiple treatment modalities, and current practice varies widely. In this Review, we summarise evidence for the treatment of melanoma brain metastases, and discuss the rationale and evidence for combination modalities, highlighting areas for future research.
authors.affiliation: Department of Oncology, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, UK. Electronic address: Thankamma.ajithkumar@addenbrookes.nhs.uk.
authors.forename: Thankamma
authors.initials: T
authors.lastname: Ajithkumar
authors.affiliation: Department of Oncology, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Parkinson
authors.affiliation: Department of Oncology, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Fife
authors.affiliation: Department of Oncology, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, UK.
authors.forename: Pippa
authors.initials: P
authors.lastname: Corrie
authors.affiliation: Department of Oncology, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Jefferies
mesh_terms: D000818:Animals; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D016371:Cranial Irradiation; D006801:Humans; D008545:Melanoma / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D058990:Molecular Targeted Therapy; D019635:Neurosurgical Procedures; D011237:Predictive Value of Tests; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome