Two combined treatments, ipilimumab and nivolumab, have positive results in patients with stage 4 melanoma brain metastases, according to one study.
A brain metastasis is cancer that originates from cancer in another part of the body that spreads to the brain. Cancers of the lung, breast, kidney, colon and melanoma frequently cause brain metastases.
Melanoma very commonly refers to cancer skin, but also mucous membranes (mouth, anal canal, vagina) or even the eye. Melanoma is on the rise in Western countries. In France, there are 10,000 new cases each year. Researchers from MD Anderson Cancer Center from the University of Texas conducted a study published in the New England Journal of Medicine. The latter reveals that a immunotherapy combined helped reduce melanoma that has spread to the brain.
Significant improvement in survival rate
“As the treatment of stage 4 melanoma has improved a lot in recent years, our patients with brain metastases remained the most needy group, they had the worst prognosis, so we are very excited about these. results, “said Hussein Tawbi, lead author of the study.
Note that we speak of “stage 4” when the melanoma has spread to other parts of the body. It is a serious condition. The researchers provided immunotherapy, combining theipilimumab and the nivolumab to 94 patients. This treatment makes it possible to simultaneously attack cerebral diseases, but also extra-cranial diseases. Hussein Tawbi continues, “Historically, the overall one-year survival rate for patients with brain metastases is less than 20%, with the combination of immunotherapy in this study it is 82%.”
Immunotherapy in favor of radiotherapy
Another conclusion of the study, combination immunotherapy saves time. Indeed, radiotherapy is very effective in treating small metastases before starting immunotherapy, with a four week break between the two types of treatment.
Often, however, the original metastases are destroyed, but new ones occur during this four-week break. “We have shown that you don’t have to wait for radiation, you can initiate early immunotherapy on all patients and wait for tumors in the brain to respond, as well as those outside the brain,” explains the author. of the study.
Be careful with side effects
The researchers paid particular attention to the side effects associated with immunotherapy. A total of 34 patients experienced side effects related to the central nervous system. The headache was the most common. Among them, seven people had more serious consequences, such as swelling of the brain, cerebral hemorrhage and syncope. These side effects were also similar to those of patients who benefited from combined immunotherapy, but without having brain metastases.
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