Gabrielle J. Williams , Angela M. Hong , John F. Thompson
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Treatment of melanoma brain metastases with radiation and immunotherapy or targeted therapy: A systematic review with meta-analysis
Background
Patients with melanoma brain metastases are now frequently treated with immunotherapy (IMT) or targeted therapy (TT). The aim of this systematic review was to determine relative survival outcomes after combining radiotherapy (RT) with IMT or TT.
Methods
126 studies were identified by searching Medline, Embase and Cochrane CENTRAL (to 7Aug 2023).
Results
Multivariable analyses showed that the risk of death was reduced by 30 % for combined stereotactic radiosurgery (SRS)+IMT compared to IMT alone, by 65 % for patients treated with SRS+anti-PD1 and by 59 % for patients treated with SRS+anti-CTLA4 and/or anti-PD1 (HR 0.41, 95 %CI 0.31–0.54) compared to SRS alone. Four studies compared SRS+anti-CTLA4 with SRS+anti-PD1, showing a 42 % reduction in risk of death with SRS+anti-PD1 treatment. Combined treatment with SRS+TT showed a 59 % reduction in risk compared to SRS alone.
Conclusion
The systematic review suggests a substantial survival benefit for combining SRS with IMT or TT for patients with melanoma brain metastases.
期刊介绍：
Critical Reviews in Oncology/Hematology publishes scholarly, critical reviews in all fields of oncology and hematology written by experts from around the world. Critical Reviews in Oncology/Hematology is the Official Journal of the European School of Oncology (ESO) and the International Society of Liquid Biopsy.
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