Synergistic efficacy of intrathecal PD-1 blockade combined with whole-brain radiotherapy for melanoma leptomeningeal metastases: A real-world analysis.

Key Points

• This study investigates the combined effects of intrathecal PD-1 blockade and whole-brain radiotherapy on survival outcomes in melanoma leptomeningeal metastases.
• Retrospective analysis of 20 patients with melanoma leukomeningeal metastasis treated with PD-1 antibodies and/or whole-brain radiotherapy.
• Cohorts were compared based on treatment type: IT Monotherapy vs. Combination Therapy within 30 days.
• Survival analyses were conducted using Kaplan-Meier and Log-rank tests.
• Combination therapy yields median overall survival (OS) of 45.3 weeks versus 20.1 weeks for monotherapy (HR 0.30, 95% CI 0.04-0.68, P=0.021).
• Intracranial progression-free survival (iPFS) significantly improved with combination therapy (23.0 weeks vs. 10.0 weeks, P < 0.001).
• No significant difference in grade ≥ 2 adverse events or unexpected severe neurotoxicity was found between treatment groups.