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Radiotherapy and immunotherapy: Can this combination change the prognosis of patients with melanoma brain metastases?

  • D. Franceschini
    Correspondence
    Corresponding author.
    Affiliations
    Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy
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  • C. Franzese
    Affiliations
    Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy
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  • P. Navarria
    Affiliations
    Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy
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  • A.M. Ascolese
    Affiliations
    Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy
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  • F. De Rose
    Affiliations
    Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy
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  • M. Del Vecchio
    Affiliations
    Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Via Giacomo Venezian, 1, 20133 Milano, Italy
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  • A. Santoro
    Affiliations
    Department of Biomedical Sciences, Humanitas University, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy

    Department of Oncology and Hematology, Humanitas Cancer Center and Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy
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  • M. Scorsetti
    Affiliations
    Radiotherapy and Radiosurgery Department, Humanitas Cancer Center and Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy

    Department of Biomedical Sciences, Humanitas University, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy
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Published:August 18, 2016DOI:https://doi.org/10.1016/j.ctrv.2016.08.003

      Highlights

      • Brain metastases from melanoma are common and loaded with a dismal prognosis.
      • Immune checkpoint inhibitors revolutionized the prognosis of stage IV melanoma.
      • Immunotherapy and radiotherapy can be combined with a synergistic action.

      Abstract

      Brain metastases are a common occurrence in patients with melanoma. Prognosis is poor. Radiotherapy is the main local treatment for brain metastases. Recently, immunotherapy (i.e. immune checkpoints inhibitors) showed a significant impact on the prognosis of patients with metastatic melanoma, also in the setting of patients with brain metastases. Despite various possible treatments, survival of patients with melanoma brain metastases is still unsatisfactory; new treatment modalities or combination of therapies need to be explored. Being immunotherapy and radiotherapy alone both efficient in the treatment of melanoma brain metastases, the combination of these two therapies seems logical. Moreover radiotherapy can improve the efficacy of immunotherapy and the immune system plays a relevant role in the action of radiotherapy. Preclinical data support this combination. Clinical data are more contradictory. In this review, we will discuss available therapies for melanoma brain metastases, focusing on the preclinical and clinical available data supporting the possible synergism between radiotherapy and immunotherapy.

      Keywords

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