title: Radiosurgery/stereotactic radiotherapy in combination with immunotherapy and targeted agents for melanoma brain metastases.
abstract: The clinical landscape of advanced melanoma drastically changed after the introduction of both targeted therapies and immunotherapy. This rapid development in systemic therapies led to a change in the management of patients with brain metastases, with the subsequent need to re-assess the role of local therapies, in particular stereotactic radiosurgery (SRS). Areas covered: In this non-systematic review, we report on the current knowledge on the use of SRS in combination with immunotherapy and BRAF/MEK inhibitors for patients with melanoma brain metastases, as well as ongoing trials in this field. Expert commentary: It is now more common to observe patients with melanoma brain metastases with better performance status and prolonged life expectancy. A combination of targeted therapy and immunotherapy, in different sequences, has been shown to be feasible and well tolerable, on the basis of retrospective reports. Additional data from ongoing prospective trials are however needed to confirm or not these findings and better explore the efficacy of the combination.
authors.affiliation: a Department of Oncology , University of Torino , Torino , Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Trino
authors.affiliation: b Radiation Oncology , Città della Salute e della Scienza University Hospital , Torino , Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Mantovani
authors.affiliation: b Radiation Oncology , Città della Salute e della Scienza University Hospital , Torino , Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Badellino
authors.affiliation: a Department of Oncology , University of Torino , Torino , Italy.|b Radiation Oncology , Città della Salute e della Scienza University Hospital , Torino , Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
authors.affiliation: a Department of Oncology , University of Torino , Torino , Italy.|c Radiation Oncology , San Luigi Gonzaga University Hospital , Orbassano , Italy.
authors.forename: Andrea Riccardo
authors.initials: AR
authors.lastname: Filippi
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000494:pharmacology; D001932:Brain Neoplasms / Q000556:secondary / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008545:Melanoma / Q000473:pathology / Q000628:therapy; D020929:Mitogen-Activated Protein Kinase Kinases / Q000037:antagonists & inhibitors; D058990:Molecular Targeted Therapy; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors; D016634:Radiosurgery / Q000379:methods*; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy
chemical_list: D000970:Antineoplastic Agents; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf; D020929:Mitogen-Activated Protein Kinase Kinases
keywords: Brain metastases; dabrafenib; immunotherapy; ipilimumab; melanoma; nivolumab; pembrolizumab; radiosurgery; stereotactic radiotherapy; trametinib; vemurafenib