18:40 - 19:15
Room: Emerald Ballroom
Rapid Fire Abstract Session (Non-CME)
Chair/s:
Mark B. Faries, Richard L. White, Jr.
Overall survival and outcome of melanoma patients with brain metastasis after the FDA approval of checkpoint inhibitors and BRAF and MEK inhibitors
Elham Vosoughi, Jee Min Lee, James R. Miller, Mehdi Nosrati, David Minor, Roy Abendroth, John W. Lee, Brian T. Andrews, Lewis Z. Leng, Max Wu, Mohammed Kashani-Sabet, Kevin B. Kim

Background: Patients with melanoma with BM have a poor prognosis with historical series showing a median overall survival (OS) of ~5 months. Novel BRAF/MEK inhibitors and checkpoint inhibitors have dramatically improved OS in patients with advanced melanoma, but demonstrated mostly in those without BM. We evaluated OS and clinical outcomes of patients with BM in the era of these novel therapies.

Materials and Methods: We performed a retrospective review of the medical records of melanoma patients with BM diagnosed between 01/2011 and 06/2015.

Results: We identified 79 patients with BM. The median time from primary melanoma diagnosis to BM was 3.2 yrs (range, 0-29.8 yrs), and the median time from stage IV diagnosis to BM was 2 months (range, 0-103 months). The stage prior to the BM diagnosis was II in 6 (7.6%) IIIA in 1 (1.3%), IIIB in 9 (11.4%), IIIC in 3 (3.8%), IV(M1a) in 6 (7.6%), IV(M1b) in 8 (10.1%) and IV(M1c) in 25 (31.6%). Six (7.6%) patients had brain metastasis as the only site of distant metastasis, and 36 (45.6%) patients had neurological symptoms at BM diagnosis. Twenty-nine (36.7%) had V600 BRAF-mutant melanoma. Thirty-four (43.0%) underwent surgical resection, and 52 (65.8%) were treated with stereotactic radiosurgery. 39 (49.4%), 28 (35.4%) and 24 (30.4%) patients received CTLA-4Ab, PD-1Ab and BRAF(+/-MEK) inhibitors, respectively. Of 55 (69.6%) patients who have died of melanoma progression, 30 (40.0%) died with progressing BM. The median OS from the diagnosis of BM was 12.8 months (range, 1.1-64.8 months), and the median OS from the time of a stage IV diagnosis was 18.2 months (range, 1.4-158.4 months). The median OS from the time of the first stereotactic radiosurgical treatment was 14 months (range, 1-63 months).

Conclusion: Our finding suggests that OS of patients with BM has been significantly improved in the new era of the novel melanoma therapies.


Reference:
22-06
Session:
Session 22: Rapid Fire Abstract Session: Cancer Metastasis & Treatment
Presenter/s:
Elham Vosoughi
Presentation type:
Rapid Fire Oral Presentation
Room:
Emerald Ballroom
Chair/s:
Mark B. Faries, Richard L. White, Jr.
Date:
Friday, April 21, 2017
Time:
19:05 - 19:10
Session times:
18:40 - 19:15