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Table 4 Selected studies assessing the efficacy and toxicity of SRS and immunotherapy for the treatment of melanoma brain metastases

From: Stereotactic radiosurgery combined with nivolumab or Ipilimumab for patients with melanoma brain metastases: evaluation of brain control and toxicity

Authors Patients (n) Treatment Median survival (months) Brain control Neurotoxicity Brain necrosis (% of patients)
Knisely et al., 2012 [22] 16 Ipi after SRS 21.3 NR NR NR
11 Ipi before SRS 19.8 NR NR NR
50 SRS alone 4.9 NR NR NR
Kiess et al., 2015 [23] 15 Concurrent SRS and Ipi (within 1 month) 1-year 65% 1-year LC 100% Grade 2, 33% Grade 3, 26% Early and late RN 50% of patients treated during or before Ipi and 13% of patients treated after Ipi.
19 Nonconcurrent, SRS before Ipi (median 3 months) 1-year 56% 1-year LC 87% Grade 2, 10% Grade 3, 6% Grade 4, 3%
12 Nonconcurrent, SRS after Ipi (median 2 months) 1-year 40% 1-year LC 89%
Ahmed et al., 2016 [24] 26 SRS/SRT and Nivo 78% (1-year 55%) 6-month and 1-year DBC 61 and 38% 6-month and 1-year LC 89 and 82% Grade 2, 37% 27%
Qian et al., 2016 [25] 33 SRS and concurrent IPI (1) or Pembro (14) 19.1 NR NR NR
42 Nonconcurrent SRS and Ipi (35) or Pembro (7) 9 NR NR NR
Choong et al., 2017 [26] 28 Concurrent SRS and Ipi (within 6 weeks) 7.5 (1-year 40%) 7.5 months NR 0%
11 Concurrent SRS and Nivo (within 6 weeks) 20.4 (1-year 78%) 12.7 months NR 18%
Cohen-Inbar et al., 2017 [27] 32 Ipi before or during SRS 1-year 59.4% 1-year LC and DBF 54.4 and 15.8% NR 31%
14 Ipi after SRS 1-year 33% 1-year LC and DBF 16.5 and 26.8% NR 7%
Gaudi-Marqueste et al., 2017 [28] 21 SRS before Ipi (21), Nivo (17), both (6) Ipi, 8.6 (1-year 41.2%) Nivo,12 (1-year 63%) NR NR NR
Patel et al., 2017 [29] 20 Ipi plus SRS (whitin 4 months) 8 (1-year 37.1%) 1-year LC and DBF 71 and 12% NR 18% at 1 year
Skrepnik et al., 2017 [30] 25 Ipi before or concurrent (within 1 month) 35 (1-year and 2-year 83 and 64%) 16.7 (1-year and 2-year 52 and 34.8%) NR 20.7 5% symptomatic
Chen et al., 2018 [31] 23 (28)° concurrent SRS-SRT and Ipi or Pembro 24.7 (1-year 75%) 1-year LC 88% Grade 2, 42% Grade 3, 0% 27% of 22 metastases confirmed by histology
12 (51)° Nonconcurrent SRS-SRT and Ipi or Pembro 14.5 (1-year 53%) 1-year LC 79% Grade 2, 35% Grade 3, 33%
Nardin et al., 2018 [32] 25 SRS and Pembro 15.3 8.4 (6-months LC 80%) NR 6.8%
Current series 45 concurrent SRS-SRT and Nivo (within 1 week) 22 (1-year 78%) 1-year 42% 1-year LC and DBC 85 and 46% Grade 3, 11% 25% at 1-year
35 Concurrent SRS-SRT and Ipi (within 1 week) 14.7 (1-year 68%) 1-year 17% 1-year LC and DBC 70 and 20% Grade 3, 6% 17% at 1 year
  1. Ipi Ipilimumab, Nivo Nivolumab, Pembro Pembrolizumab, SRS Stereotactic radiosurgery, SRT Stereotactic radiotherapy, LC local control, DBC distant brain control, NR not reported; ° Study including patients with brain metastases from melanoma, non small-cell lung cancer, and renal cell carcinoma