Evidence map›Paper›PMID 26712903›Full record

ArticleAnnals of oncology : official journal of the European Society for Medical Oncology2016

Clinical outcomes of melanoma brain metastases treated with stereotactic radiation and anti-PD-1 therapy.

K A Ahmed, D G Stallworth, Y Kim, P A S Johnstone, L B Harrison, J J Caudell, H H M Yu, A B Etame, J S Weber, G T Gibney

2 registry-linked trialsAbstract read
PubMed Publisher
In one paragraph

Article in Annals of oncology : official journal of the European Society for Medical Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 131 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
131citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03971214 phase1unknown statusnot on this mapstarted 2019, after this paper: background citation

Pilot Study on PD-1 Inhibitors Consolidation After Standard First-line Chemotherapy and Radiotherapy in Extensive-stage Small Cell Lung Cancer

TypeinterventionalSponsorChinese Academy of Medical SciencesRan2019 to 2021Enrolled6ConditionsExtensive-stage Small Cell Lung Cancer, Radiotherapy, ImmunotherapyArmsPD-1 inhibitor JS-001
NCT04186013 phase2active not recruitingnot on this mapstarted 2019, after this paper: background citation

Efficacy of Atezolizumab Concurrent With Radiotherapy in Patients With Muscle-invasive Bladder cáncer (Study ATEZOBLADDERPRESERVE)

TypeinterventionalSponsorSpanish Oncology Genito-Urinary GroupRan2019 to 2027Enrolled39ConditionsBladder CancerArmsAtezolizumab Injection [Tecentriq], External Beam Radiation Therapy (EBRT)
3 · Its place in the literature

Who cites it

131 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  8. Integrated approaches to sensitizing melanoma to radiotherapy.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026
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71 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

K A AhmedDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
D G StallworthDepartment of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
Y KimDepartment of Biostatistics, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
P A S JohnstoneDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
L B HarrisonDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
J J CaudellDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
H H M YuDepartment of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
A B EtameDepartment of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
J S WeberNYU Langone Medical Center, New York.
G T GibneyDepartment of Oncology, Georgetown-Lombardi Comprehensive Cancer Center, Washington Department of Medicine, Medstar-Georgetown University Hospital, Washington, USA geoffrey.t.gibney@gunet.georgetown.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe anti-programmed death-1 (anti-PD-1) therapy nivolumab has significant clinical activity in patients with metastatic melanoma. However, little is known about the safety and outcomes in patients receiving anti-PD-1 therapy and stereotactic radiation for the treatment of brain metastases (BMs). PATIENTS AND

methodsData were analyzed retrospectively from two prospective nivolumab protocols enrolling 160 patients with advanced resected and unresectable melanoma at a single institution. Patients were included if BMs were diagnosed and treated with stereotactic radiation within 6 months of receiving nivolumab. The primary end point of this study was neurotoxicity; secondary end points included BM control and survival.

resultsTwenty-six patients with a total of 73 BMs treated over 30 sessions were identified. Radiation was administered before, during and after nivolumab in 33 lesions (45%), 5 lesions (7%), and 35 lesions (48%), respectively. All BMs were treated with stereotactic radiosurgery (SRS) in a single session except 12 BMs treated with fractionated stereotactic radiation therapy, nine of which were in the postoperative setting. One patient experienced grade 2 headaches following SRS with symptomatic relief with steroid treatment. No other treatment-related neurologic toxicities or scalp reactions were reported. Eight (11%) local BM failures with a ≥20% increase in volume were noted. Of these lesions, hemorrhage was noted in 4, and edema was noted in 7. Kaplan-Meier estimates for local BM control following radiation at 6 and 12 months were 91% and 85%, respectively. Median overall survival (OS) from the date of stereotactic radiation and nivolumab initiation was 11.8 and 12.0 months, respectively, in patients receiving nivolumab for unresected disease (median OS was not reached in patients treated in the resected setting).

conclusionsIn our series, stereotactic radiation to melanoma BMs is well tolerated in patients who received nivolumab. BM control and OS appear prolonged compared with standard current treatment. Prospective evaluation is warranted.

Indexed as

Combined Modality TherapyAdultAgedAntibodies, MonoclonalBrain NeoplasmsFemaleHumansMaleMelanomaMiddle AgedNivolumabProgrammed Cell Death 1 ReceptorRadiosurgeryRetrospective StudiesAntibodies, MonoclonalNivolumabPDCD1 protein, humanProgrammed Cell Death 1 Receptoranti-PD-1 therapymelanomanivolumabstereotactic radiation

Identifiers

PMID26712903

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.