Multicenter cohort study of survival in melanoma patients with brain metastases: update of Melanoma Graded Prognostic Assessment

The propensity of melanoma to metastasize to the braine remains a common and serious feature of this disease. A multicenter retrospective study evaluated survival and prognostic factors of patients with newly diagnosed melanoma brain metastases (MBMs). The median survivals for cohorts A (1985-2007, n=481), B (2006-2015, n=823), and C (2015-2021, n=1,796) were 7.7, 9.8, and 16.6 months. In combined multivariable analyses, significant prognostic factors for survival were higher Karnofsky Performance Status, fewer MBMs, absence of extracranial metastases, lower serum LDH, and no immunotherapy before MBM. These factors were incorporated into the updated Melanoma Graded Prognostic Assessment (GPA). The combined median and 3-year survivals for patients with GPA 0-1, 1.5-2, and 2.5-4.0 were 5.4, 13.2, and 43.2 months and 12.4%, 28.8%, and 51.6%, respectively. The authors conclude that prognostic factors have changed and survival has improved for patients with MBM but varies widely by GPA.