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:
CreatorsEmailORCIDORCID Put Code
Trommer-Nestler, MaikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Marnitz, SimoneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kocher, MartinUNSPECIFIEDorcid.org/0000-0002-5674-9227UNSPECIFIED
Ruess, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlaak, MaxUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Theurich, SebastianUNSPECIFIEDorcid.org/0000-0001-5706-8258UNSPECIFIED
von Bergwelt-Baildon, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Morgenthaler, JanisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jablonska, KarolinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Celik, ErenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruge, Maximilian, IUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baues, ChristianUNSPECIFIEDorcid.org/0000-0003-1733-6064UNSPECIFIED
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:
KeywordsLanguage
IMMUNE CHECKPOINT THERAPY; CLINICAL-OUTCOMES; RADIATION-THERAPY; PSEUDOPROGRESSION; IPILIMUMAB; TUMOR; RADIOTHERAPY; NIVOLUMAB; DIAGNOSIS; EFFICACYMultiple languages
Biochemistry & Molecular Biology; Chemistry, MultidisciplinaryMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/17366

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