Retrospective study of clinical outcomes of ICIs with or without SRS for melanoma brain metastases

Upfront dual checkpoint blockade with immune checkpoint inhibitors (ICIs) has demonstrated efficacy for treating melanoma brain metastases (MBM) in asymptomatic patients. A retrospective study at Moffitt Cancer Center (Tampa, FL) compared clinical outcomes of dual ICI with nivolumab and ipilimumab with or without stereotactic radiosurgery (SRS) for previously untreated MBM. The study included 25 patients with 74 MBM who received ICIs alone and 24 patients with 84 MBM who received ICIs plus SRS. There was no increased toxicity in the SRS group. The figure shows that there were no significant differences between the groups in 1-year overall survival (72% with SRS versus 71% without SRS; p=0.20) distant intracranial and 1-year control (63% versus 51%; p=0.26). The 1-year local control was significantly better with SRS (92% versus 64%; p=0.002). On multivariate analysis, local control was improved with combination therapy (aHR 0,38; p=0.01).