Recent studies report encouraging results for BRAF/MEK inhibitors and anti-PD-1/anti-CTLA-4 antibodies in the treatment of patients with melanoma brain metastases (MBM). However, a substantial number of patients still progress and die from brain metastases.

Retrospective studies suggest an overall survival benefit with acceptable toxicity for stereotactic ablative radiotherapy combined with BRAF/MEK inhibitors or immune checkpoint inhibitors.

Treatment decisions for patients with MBM should be made by an interdisciplinary tumor board in order to establish the best possible treatment for the individual patient.

For patients with MBM, further research on brain-specific mechanisms of therapy resistance and prospective clinical studies are essential.