A survival tree of advanced melanoma patients with brain metastases treated with immune checkpoint inhibitors

Not, O.J. van; Wind, T.T.; Ismail, R.K.; Bhattacharya, A.; Jalving, M.; Blank, C.U.; Aarts, M.J.B.; Berkmortel, F.W.P.J. van den; Boers-Sonderen, M.J.; Eertwegh, A.J.M. van den; Groot, J.W.B. de; Haanen, J.B.; Kapiteijn, E.; Bloem, M.; Piersma, D.; Rijn, R.S. van; Stevense-den Boer, M.; Veldt, A.A.M. van der; Vreugdenhil, G.; Wouters, M.W.J.M.; Blokx, W.A.M.; Suijkerbuijk, K.P.M.; Fehrmann, R.S.N.; Hospers, G.A.P.

doi:doi:10.3390/cancers15112922

The efficacy of immune checkpoint inhibitors (ICIs) in patients with advanced melanoma
that develop brain metastases (BM) remains unpredictable. In this study, we aimed to identify
prognostic factors in patients with melanoma BM who are treated with ICIs. Data from advanced
melanoma patients with BM treated with ICIs in any line between 2013 and 2020 were obtained from
the Dutch Melanoma Treatment Registry. Patients were included from the time of the treatment of
BM with ICIs. Survival tree analysis was performed with clinicopathological parameters as potential
classifiers and overall survival (OS) as the response variable. In total, 1278 patients were included.
Most patients were treated with ipilimumab–nivolumab combination therapy (45%). The survival
tree analysis resulted in 31 subgroups. The median OS ranged from 2.7 months to 35.7 months. The
strongest clinical parameter associated with survival in advanced melanoma patients with BM was
the...Show moreThe efficacy of immune checkpoint inhibitors (ICIs) in patients with advanced melanoma
that develop brain metastases (BM) remains unpredictable. In this study, we aimed to identify
prognostic factors in patients with melanoma BM who are treated with ICIs. Data from advanced
melanoma patients with BM treated with ICIs in any line between 2013 and 2020 were obtained from
the Dutch Melanoma Treatment Registry. Patients were included from the time of the treatment of
BM with ICIs. Survival tree analysis was performed with clinicopathological parameters as potential
classifiers and overall survival (OS) as the response variable. In total, 1278 patients were included.
Most patients were treated with ipilimumab–nivolumab combination therapy (45%). The survival
tree analysis resulted in 31 subgroups. The median OS ranged from 2.7 months to 35.7 months. The
strongest clinical parameter associated with survival in advanced melanoma patients with BM was
the serum lactate dehydrogenase (LDH) level. Patients with elevated LDH levels and symptomatic
BM had the worst prognosis. The clinicopathological classifiers identified in this study can contribute
to optimizing clinical studies and can aid doctors in giving an indication of the patients’ survival
based on their baseline and disease characteristics.
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A survival tree of advanced melanoma patients with brain metastases treated with immune checkpoint inhibitors