What question did this study set out to answer?

To evaluate differences in the incidence and timing of brain metastasis, as well as progression-free and overall survival, based on first-line systemic therapy in patients with advanced melanoma.

April 1, 2023Journal for ImmunoTherapy of CancerOpen Access

Brain metastasis and survival outcomes after first-line therapy in metastatic melanoma: a multicenter DeCOG study on 1704 patients from the prospective skin cancer registry ADOREG

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To evaluate differences in the incidence and timing of brain metastasis, as well as progression-free and overall survival, based on first-line systemic therapy in patients with advanced melanoma.
Analyzed 1704 patients with stage IIIC–IV metastatic melanoma without baseline brain metastases from the prospective multicenter German ADOREG registry (916 BRAF wild-type and 788 BRAF V600-mutant).
Compared first-line regimens—including anti-PD-1 monotherapy, combined anti-CTLA-4 plus anti-PD-1, and BRAF plus MEK targeted therapy—over a median follow-up of 40.4 months.
In BRAF-mutant melanoma, 24-month brain metastasis incidence was 30.3% with BRAF+MEK versus 22.2% with CTLA-4+PD-1 and 14.0% with PD-1; targeted therapy resulted in earlier brain metastasis than CTLA-4+PD-1 (HR 0.560, 95% CI 0.332–0.945, p=0.030) and PD-1 (HR 0.575, 95% CI 0.372–0.888, p=0.013).
First-line CTLA-4+PD-1 improved overall survival in BRAF-mutant patients compared to PD-1 alone (HR 1.97, 95% CI 1.122–3.455, p=0.018) and BRAF+MEK targeted therapy (HR 2.41, 95% CI 1.432–4.054, p=0.001).
In BRAF wild-type patients, dual CTLA-4+PD-1 therapy demonstrated no significant differences in brain metastasis-free survival, progression-free survival, or overall survival compared with PD-1 monotherapy.

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Implication

Prospective cohort study reveals first-line immunotherapy delays brain metastases over targeted therapy in BRAF-mutant melanoma, highlighting superior survival with dual checkpoint inhibition.

Cite This Study

Franklin et al. (2023) studied this question.

synapsesocial.com/papers/6aaa1dff81b585e3dc1c0716 https://doi.org/10.1136/jitc-2022-005828

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Implication

Prospective cohort study reveals first-line immunotherapy delays brain metastases over targeted therapy in BRAF-mutant melanoma, highlighting superior survival with dual checkpoint inhibition.

Brain metastasis and survival outcomes after first-line therapy in metastatic melanoma: a multicenter DeCOG study on 1704 patients from the prospective skin cancer registry ADOREG

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Implication

Cite This Study

Brain metastasis and survival outcomes after first-line therapy in metastatic melanoma: a multicenter DeCOG study on 1704 patients from the prospective skin cancer registry ADOREG

Key Points

Discussion

Implication

Cite This Study

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