Evaluating immunotherapy with surgery for melanoma in the brain

This study investigated whether surgery before immunotherapy was more effective than immunotherapy alone for patients with melanoma that spread to the brain. This study concluded that patients who had surgery before immunotherapy survived for longer than patients who only had immunotherapy.

Melanoma is one of the most common types of cancer that can spread to the brain. About 75% of patients with advanced-stage melanoma develop tumors in the brain. Typical treatments for these patients include surgery and radiation therapy, which is often given before surgery.

Immunotherapy has been effective for many patients with melanoma. Previous studies have shown that patients with tumors in the brain may also benefit from immunotherapy. Whether surgery followed by immunotherapy is safe and effective for these patients remains unclear.

This study included 142 patients. All patients had melanoma that metastasized (spread) to the brain. All patients were treated with immunotherapy. 79 patients also received surgery to remove the tumors in the brain. Surgery was given before or after immunotherapy. Patients were followed-up for an average of 27 months.

On average, patients who had surgery before immunotherapy survived longer than patients who had immunotherapy only (22.7 months vs. 10.8 months). On average, patients who had surgery after immunotherapy survived for an average of 9.4 months.

Treatment with immunotherapy only was associated with a 72% higher risk of mortality compared to treatment with immunotherapy after surgery. Patients who did not have radiation therapy before surgery had a 7-fold higher risk of mortality compared to patients who did.

This study concluded that surgery before immunotherapy was more effective than immunotherapy alone in patients with melanoma tumors that spread to the brain.

This study has a small patient population. This study is also retrospective. This means that the study looked back in time to analyze data. Also, immunotherapy regimens were chosen for the patients by their doctor. These factors may limit the conclusions that can be drawn from these results. More studies are needed to confirm these results.

Talk to your oncologist about the potential for surgical solutions.