Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2025
Impact of immunotherapy on outcomes of cutaneous melanoma and concurrent brain metastasis: a surveillance, epidemiology, and end results analysis of 2010-2020.
СтатьяНазвание и аннотация: Перевод в очереди
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Kelbert James, Ghalambor Tara, Sparling Kennedy, Nosova Kristin, Georges Joseph, Bina Robert W
Аннотация
INTRODUCTION: Melanoma has the greatest incidence of brain metastases among all cancers and once patients develop melanoma brain metastases (MBM) it is the primary contributor to patient mortality. Following the FDA approval of immune checkpoint inhibitors in 2011, there has been a significant reduction in melanoma patient mortality. Therefore, we investigated the impact of immunotherapy on overall survival (OS) pre and post implementation of immunotherapy in the management of MBM.
METHODS: Data from patients with MBM upon diagnosis and seen between 2010-2012 and 2018-2020 were collected from Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier survival curves, cox regression models, and log rank tests were conducted using case-listing survival data from Seer*Stat 4.8.2.
RESULTS: There were a total of 1426 patients with MBM at diagnosis: 403 patients (304 men and 99 women) from 2010 to 2012 and 1023 patients (715 men and 308 women) from 2018 to 2020. Median OS for patients from the 2010-2012 and 2018-2020 group was 4 months (95 % CIs: 4-5 month) and 14 months (95 % CIs: 12-19 months), respectively. Patients from 2010 to 2012 had a significantly worse (p = 1e-06) 5-year OS of 9.7 % (95 % CIs: 7.2-13.0 %) compared with 33.4 % (95 % CIs: 29.9-37.3 %) in 2018-2020. When stratified by sex, median OS in men was statistically worse compared to women in the 2010-2012 time period, (HR 2.11, p < 2.2e-16), but demonstrated virtually no difference in 2018 to 2020 (HR 1.02, p = 0.63).
CONCLUSION: The introduction of immunotherapy with checkpoint inhibitors significantly improved OS among patients with MBM and may have helped mitigate historical disparities in survival between men and women.
METHODS: Data from patients with MBM upon diagnosis and seen between 2010-2012 and 2018-2020 were collected from Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier survival curves, cox regression models, and log rank tests were conducted using case-listing survival data from Seer*Stat 4.8.2.
RESULTS: There were a total of 1426 patients with MBM at diagnosis: 403 patients (304 men and 99 women) from 2010 to 2012 and 1023 patients (715 men and 308 women) from 2018 to 2020. Median OS for patients from the 2010-2012 and 2018-2020 group was 4 months (95 % CIs: 4-5 month) and 14 months (95 % CIs: 12-19 months), respectively. Patients from 2010 to 2012 had a significantly worse (p = 1e-06) 5-year OS of 9.7 % (95 % CIs: 7.2-13.0 %) compared with 33.4 % (95 % CIs: 29.9-37.3 %) in 2018-2020. When stratified by sex, median OS in men was statistically worse compared to women in the 2010-2012 time period, (HR 2.11, p < 2.2e-16), but demonstrated virtually no difference in 2018 to 2020 (HR 1.02, p = 0.63).
CONCLUSION: The introduction of immunotherapy with checkpoint inhibitors significantly improved OS among patients with MBM and may have helped mitigate historical disparities in survival between men and women.