Table 4.
Previous studies evaluating melanoma patients with leptomeningeal disease.
| Authors | Number of Patients, Time of Enrolment | Treatments | Median OS | Factors Associated with Survival in Multivariate Analysis |
|---|---|---|---|---|
| Ferguson et al. |
N = 178 Between 1999 and 2015 |
> RT: N = 98 | All patients: 3.5 months Untreated patients: 0.7 months Any treatment: 4.4 months |
|
| > Systemic therapy: N = 11 - Targeted therapy: N = 60 - Immunotherapy: N = 12 - Chemotherapy: N = 89 - Intra-thecal therapy: N = 64 |
Patients treated with: - RT: 4.6 months - Intrathecal therapy: 7.8 months - Immunotherapy: 2.9 months - Targeted therapy: 8.2 months - Chemotherapy: 4.7 months |
Improved OS was associated with: - Good PS (ECOG 0) (HR 2.1, 95% CI 1.3–3.1, p = 0.001) - Lack of concurrent systemic disease (HR 0.4, 95% CI 0.3–0.8, p = 0.025) - Treatment with targeted therapy (HR 0.6, 95% CI 0.4–0.9, p = 0.006) or intra thecal therapy (HR 0.5, 95% CI 0.3–0.8, p = 0.002) after LM diagnosis Shorter OS was associated with: - Presence of neurological symptoms (HR 1.6, 95% CI 1.1–2.4, p = 0.001) - Any systemic therapy prior to LM diagnosis (HR 1.6, 95% CI 1.0–2.5, p = 0.05) |
||
| Arasaratnam et al. |
N = 14 Between 2012 and 2015 |
> RT: N = 11 | All patients: 5.2 months | NA |
| > Systemic therapy: N = 11 - Targeted therapy: N = 4 - IPI: N = 2 - anti-PD1: N = 5 -IPI + NIVO: N = 1 |
Patients treated with: - IPI: 3 months - anti-PD1: 7.1 months - BRAF inh: 7.2 months |
|||
| Geukes Foppen et al. |
N = 39 Between 2010 and 2015 |
> RT: N = 15 | Untreated patients (N = 14): 2.9 weeks |
Shorter OS was associated with elevated serum LDH (p < 0.001) and S100B (p = 0.04) at LM diagnosis |
| > Systemic therapy: N = 21 - included BRAF inh: N = 14 - included IPI: N = 10 - included anti-PD1: N = 0 |
Treated with IPI or BRAF inh (N = 24): 21.7 weeks |
|||
| Hastad et al. |
N = 110 Between 1994 and 2002 |
> RT: N = 48 > Chemotherapy: N = 42 > Intrathecal therapy: N = 53 |
10 weeks | Improved OS was associated with intra-thecal chemotherapy (HR = 0.5, 95% CI 0.4–0.8, p = 0.0036) |
| Pape et al. |
N = 9 Between 2007 and 2011 |
> Combination of intra-thecal chemotherapy and systemic chemotherapy: N = 9 | 8 weeks | NA |
| Raizer et al. |
N = 40 Between 1991 and 2001 |
> Systemic chemotherapy +/− RT: NA | 4 months | NA |
RT: radiotherapy; OS: overall survival; PS: performance status; ECOG: Eastern Cooperative Oncology Group; NA: data unavailable; IPI: ipilimumab; inh: inhibitors; NIVO: nivolumab; N: number of patients; HR: hazard ratio.