Table 2.
Study of targeted therapy associated with radiation therapy in melanoma with brain metastases.
| Study | Trial Design | Drug(s) | RT | No. Patients | Adverse Events | Efficacy Data | Survival Results |
|---|---|---|---|---|---|---|---|
| Narayana A. (2013) [56] | retrospective | Vemurafenib | SRS- WBRT | 12 | 4 intratumoral bleed prior to therapy. 2 patients developed steroid dependence. 1 radiation necrosis. 2 deaths for cerebral edema. |
Symptoms improved in 64%. Radiographic responses in 36/48 (75%) Responses of index lesions (48% CR; 27% PR) |
Median OS 13.7 (months) |
| Ahmed K.A. (2015) [57] | retrospective | Vemurafenib | SRS | 24 | 1 radiation necrosis | 75% local control at 12 months | Median OS 7.2 (months) |
| Gaudy- Marqueste C. (2014) [58] | retrospective | Dabrafenib or Vemurafenib | GNRS | 30 | 3 Radiation necrosis. 3 edemas and 3 hemorrhages within 2 months after GNRS; 4 edemas and 7 hemorrhages later |
Median OS from first GNRS under BRAF-I and first dose of BRAF-I: 24.8 and 48.8 weeks, respectively | NA |
| Xu Z. (2017) [59] | retrospective | Dabrafenib or Vemurafenib | SRS | 17 | NA | Local tumor control rate at 1 year 92% | Median OS 13 (months) |
| Ly D. (2015) [60] | retrospective | Dabrafenib or Vemurafenib | SRS | 17 | 39.3% free from intratumoral hemorrhage at 1 year | Local control rate 85% at 1 year | 1year-OS 50.2% |
| Patel K.R. (2016) [63] | retrospective | Dabrafenib or Vemurafenib | SRS | 15 | Radiation necrosis (radiographic) 22.2% at 1 year; Radiation necrosis (symptomatic) 28.2% at 1 year |
1year-local failure 3.3% 1year-distant intracranial failure 63.9% |
1year-OS 64.3% |
SRS: stereotactic radiosurgery; WBRT: whole brain radiotherapy; GNRS: gamma knife radiosurgery; NA: not available; CR: complete response; PR: partial response; OS: overall survival.