Universität zu Köln

Trommer-Nestler, Maike, Marnitz, Simone, Kocher, Martin ORCID: 0000-0002-5674-9227, Ruess, Daniel, Schlaak, Max, Theurich, Sebastian ORCID: 0000-0001-5706-8258, von Bergwelt-Baildon, Michael, Morgenthaler, Janis, Jablonska, Karolina, Celik, Eren, Ruge, Maximilian, I and Baues, Christian ORCID: 0000-0003-1733-6064 (2018). Robotic Stereotactic Radiosurgery in Melanoma Patients with Brain Metastases under Simultaneous Anti-PD-1 Treatment. Int. J. Mol. Sci., 19 (9). BASEL: MDPI. ISSN 1422-0067

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Abstract

Combination concepts of radiotherapy and immune checkpoint inhibition are currently of high interest. We examined imaging findings, acute toxicity, and local control in patients with melanoma brain metastases receiving programmed death 1 (PD-1) inhibitors and/or robotic stereotactic radiosurgery (SRS). Twenty-six patients treated with SRS alone (n = 13; 20 lesions) or in combination with anti-PD-1 therapy (n = 13; 28 lesions) were analyzed. Lesion size was evaluated three and six months after SRS using a volumetric assessment based on cranial magnetic resonance imaging (cMRI) and acute toxicity after 12 weeks according to the Common Terminology Criteria for Adverse Events (CTCAE). Local control after six months was comparable (86%, SRS + anti-PD-1, and 80%, SRS). All toxicities reported were less than or equal to grade 2. One metastasis (5%) in the SRS group and six (21%) in the SRS + anti-PD-1 group increased after three months, whereas four (14%) of the six regressed during further follow-ups. This was rated as pseudoprogression (PsP). Three patients (23%) in the SRS + anti-PD-1 group showed characteristics of PsP. Treatment with SRS and anti-PD-1 antibodies can be combined safely in melanoma patients with cerebral metastases. Early volumetric progression of lesions under simultaneous treatment may be related to PsP; thus, the evaluation of combined radioimmunotherapy remains challenging and requires experienced teams.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Trommer-Nestler, Maike UNSPECIFIED UNSPECIFIED UNSPECIFIED Marnitz, Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED Kocher, Martin UNSPECIFIED orcid.org/0000-0002-5674-9227 UNSPECIFIED Ruess, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlaak, Max UNSPECIFIED UNSPECIFIED UNSPECIFIED Theurich, Sebastian UNSPECIFIED orcid.org/0000-0001-5706-8258 UNSPECIFIED von Bergwelt-Baildon, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Morgenthaler, Janis UNSPECIFIED UNSPECIFIED UNSPECIFIED Jablonska, Karolina UNSPECIFIED UNSPECIFIED UNSPECIFIED Celik, Eren UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruge, Maximilian, I UNSPECIFIED UNSPECIFIED UNSPECIFIED Baues, Christian UNSPECIFIED orcid.org/0000-0003-1733-6064 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-173663
DOI:	10.3390/ijms19092653
Journal or Publication Title:	Int. J. Mol. Sci.
Volume:	19
Number:	9
Date:	2018
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	1422-0067
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language IMMUNE CHECKPOINT THERAPY; CLINICAL-OUTCOMES; RADIATION-THERAPY; PSEUDOPROGRESSION; IPILIMUMAB; TUMOR; RADIOTHERAPY; NIVOLUMAB; DIAGNOSIS; EFFICACY Multiple languages Biochemistry & Molecular Biology; Chemistry, Multidisciplinary Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17366