Evidence map›Paper›PMID 27637745›Full record

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

Clinical outcomes of melanoma brain metastases treated with stereotactic radiosurgery and anti-PD-1 therapy, anti-CTLA-4 therapy, BRAF/MEK inhibitors, BRAF inhibitor, or conventional chemotherapy.

K A Ahmed, Y A Abuodeh, M I Echevarria, J A Arrington, D G Stallworth, C Hogue, A O Naghavi, S Kim, Y Kim, B G Patel and 9 more

Abstract read
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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. Cited by 78 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 11 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  5. SEOM-GEINO clinical guideline of systemic therapy and management of brain central nervous system metastases (2021).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2022
    Guideline
  6. Pooled it
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  9. Pulmonary complications of immune checkpoint inhibitors in patients with nonsmall cell lung cancer.European respiratory review : an official journal of the European Respiratory Society · 2019
    Pooled it
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  12. Trial
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  16. Post-SRS haemorrhage and oncological outcome of patients with melanoma brain metastases undergoing stereotactic radiotherapy.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025
    Article
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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

K A AhmedDepartment of Radiation Oncology.
Y A AbuodehDepartment of Radiation Oncology.
M I EchevarriaDepartment of Radiation Oncology.
J A ArringtonDepartment of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
D G StallworthDepartment of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
C HogueDepartment of School of Medicine, University of Louisville, Louisville.
A O NaghaviDepartment of Radiation Oncology.
S KimDepartment of Radiation Oncology.
Y KimDepartment of Biostatistics, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
B G PatelDepartment of Morsani College of Medicine, University of South Florida, Tampa.
S SarangkasiriDepartment of Radiation Oncology.
P A S JohnstoneDepartment of Radiation Oncology.
S SahebjamDepartment of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
N I KhushalaniDepartment of Cutaneous-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA.
P A ForsythDepartment of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
L B HarrisonDepartment of Radiation Oncology.
M YuDepartment of Radiation Oncology.
A B EtameDepartment of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa.
J J CaudellDepartment of Radiation Oncology jimmy.caudell@moffitt.org.

Funding

TRANSLATIONAL RESEARCHP30CA076292 · NCI · UNIVERSITY OF SOUTH FLORIDA · PI Christine O'Connell · 1998 to 2026
$93.5M
NCI NIH HHS P30 CA076292
6 · The paper itself

Abstract

backgroundThe effect of immunologic and targeted agents on intracranial response rates in patients with melanoma brain metastases (MBMs) is not yet clearly understood. This report analyzes outcomes of intact MBMs treated with single-session stereotactic radiosurgery (SRS) and anti-PD-1 therapy, anti-CTLA-4 therapy, BRAF/MEK inhibitors(i), BRAFi, or conventional chemotherapy. PATIENTS AND

methodsPatients were included if MBMs were treated with single-session SRS within 3 months of receiving systemic therapy. The primary end point of this study was distant MBM control. Secondary end points were local MBM control defined as a >20% volume increase on follow-up MRI, systemic progression-free survival, overall survival (OS) from both SRS and cranial metastases diagnosis, and neurotoxicity. Images were reviewed alongside two neuro-radiologists at our institution.

resultsNinety-six patients were treated to 314 MBMs over 119 SRS treatment sessions between January 2007 and August 2015. No significant differences were noted in age (P = 0.27), gender (P = 0.85), treated gross tumor volume (P = 0.26), or the diagnosis-specific graded prognostic assessment (P = 0.51) between the treatment cohorts. Twelve-month Kaplan-Meier (KM) distant MBM control rates were 38%, 21%, 20%, 8%, and 5% (P = 0.008) for SRS with anti-PD-1 therapies, anti-CTLA-4 therapy, BRAF/MEKi, BRAFi, and conventional chemotherapy, respectively. No significant differences were noted in the KM local MBM control rates among treatment groups (P = 0.25). Treatment with anti-PD-1 therapy, anti-CTLA-4 therapy, or BRAF/MEKi significantly improved OS on both univariate and multivariate analyses when compared with conventional chemotherapy.

conclusionIn our institutional analysis of patients treated with SRS and various systemic immunologic and targeted melanoma agents, significant differences in distant MBM control and OS are noted. Prospective evaluation of the potential synergistic effect between these agents and SRS is warranted.

Indexed as

RadiosurgeryAcrylonitrileAdolescentAdultAgedAged, 80 and overAniline CompoundsBrain NeoplasmsCombined Modality TherapyCTLA-4 AntigenDisease-Free SurvivalFemaleHumansMaleMelanomaMiddle AgedAcrylonitrileAniline CompoundsBRAF protein, humanCTLA-4 AntigenCTLA4 protein, humanMEK inhibitor IPDCD1 protein, humanProgrammed Cell Death 1 ReceptorProto-Oncogene Proteins B-rafanti-PD-1 therapybrain metastasesmelanomastereotactic radiation

Identifiers

PMID27637745
PMCPMC8890451

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.