by Dr. C.H. Weaver M.D. 2/2019
Patients who are healthy enough should receive dual checkpoint inhibitors, researchers say
Patients with malignant melanoma and small, asymptomatic brain metastases achieved long-term survival with Keytruda (pembrolizumab) monotherapy according to a recent report.
Brain metastases are a common cause of disabling neurologic complications and death in patients with metastatic melanoma and occur in up to 40% of patients.
The recently reported clinical study reported the outcomes of 23 patients with melanoma and one or more asymptomatic, untreated 5- to 20-mm brain metastases treated with Keytruda monotherapy.
Overall 26% of the patients treated with Keytruda responded for an average of 24 months. Cancer in the brain and the rest of the body responded in a similar manner suggesting the brain metastases were of similar biology to the rest of the cancer.
The average overall survival was 17 months and ~ 50% of the patients survived 2 years or longer.
Doctors are now evaluating the use of dual immunotherapy as treatment for metastatic melanoma that has spread to the brain. Patients with brain metastases should discuss these options with their treating physician and explore newer combinations of immunotherapy being evaluated in clinical trials.