In a nutshell
This article investigated the safety and effectiveness of pembrolizumab (Keytruda) for patients with melanoma and untreated brain metastasis (the spread of cancer cells from the place where they first formed to another part of the body). The authors concluded that this therapy is safe and can improve the overall survival of these patients.
Some background
Melanoma is cancer of melanocytes. These are a type of skin cell responsible for skin color. It can spread to other parts of the body, including the brain. Pembrolizumab is a standard treatment for melanoma. However, its use for patients with brain metastasis is less well known.
Methods & findings
This study involved 23 patients with new or growing small brain metastasis. Pembrolizumab was given to patients for up to 2 years. The outcomes measured were brain metastasis response (BMR; successful response to treatment), progression-free survival (PFS; the time it took for cancer to start growing again), overall survival, and side effects.
6 patients (26%) had a BMR. 8 patients were unable to test for a BMR due to cancer progression and need for radiation. The average PFS was 2 months and the average overall survival was 17 months. 48% of patients were alive at 2 years. The 2-year survival was similar to patients without brain metastasis.
Most common side effects included unsteady walk (22%), headache (17%), and 3 patients developed seizures.
The bottom line
The authors concluded that pembrolizumab treatment is active on brain metastasis and has acceptable side effects on the long-term.
The fine print
This study was partly funded by Merck, the manufacturer of pembrolizumab. This was only a phase II trial with a small number of patients. Further studies are needed to evaluate this treatment.
Published By :
Journal of clinical oncology
Date :
Nov 08, 2018
