Evidence map›Paper›PMID 29696531›Full record

ArticleJournal of neuro-oncology2018

Stereotactic radiosurgery and ipilimumab for patients with melanoma brain metastases: clinical outcomes and toxicity.

Kevin Diao, Shelly X Bian, David M Routman, Cheng Yu, Jason C Ye, Naveed A Wagle, Michael K Wong, Gabriel Zada, Eric L Chang

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neuro-oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 10 pooled it
9.7field-weighted citation impact, top 1% of its field
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

47 citing papers in PubMed, 10 syntheses or guidelines pooled it, 83 citations in OpenAlex.

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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

9 authors at 3 institutions in 1 country.

Kevin DiaoHarvard Medical School, Boston, MA, USA. kevin_diao@hms.harvard.edu.ORCID http://orcid.org/0000-0002-7092-6162
Shelly X BianDepartment of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA.
David M RoutmanDepartment of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA.
Cheng YuDepartment of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA.
Jason C YeDepartment of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA.
Naveed A WagleDepartment of Clinical Neurology, Keck School of Medicine of USC, Los Angeles, CA, USA.
Michael K WongDivision of Medical Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA.
Gabriel ZadaDepartment of Neurological Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Eric L ChangDepartment of Radiation Oncology, Keck School of Medicine of USC, Los Angeles, CA, USA.
Keck Hospital of USC · USHarvard University · USNeurological Surgery · US

Funding

USC/NORRIS COMPREHENSIVE CANCER CENTER (CORE) SUPPORTP30CA014089 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Fumito Ito · 1985 to 2026
$181.4M
NCI NIH HHS P30 CA014089
6 · The paper itself

Abstract

introductionThere is evidence that the combination of ipilimumab and stereotactic radiosurgery (SRS) for brain metastases improves outcomes. We investigated clinical outcomes, radiation toxicity, and impact of ipilimumab timing in patients treated with SRS for melanoma brain metastases.

methodsWe retrospectively identified 91 patients treated with SRS at our institution for melanoma brain metastases from 2006 to 2015. Concurrent ipilimumab administration was defined as within ± 4 weeks of SRS procedure. Acute and late toxicities were graded with CTCAE v4.03. Overall survival (OS), local failure, distant brain failure, and failure-free survival were analyzed with the Kaplan-Meier method. OS was analyzed with Cox regression.

resultsTwenty-three patients received ipilimumab concurrent with SRS, 28 patients non-concurrently, and 40 patients did not receive ipilimumab. The median age was 62 years and 91% had KPS ≥ 80. The median follow-up time was 7.4 months. Patients who received ipilimumab had a median OS of 15.1 months compared to 7.8 months in patients who did not (p = 0.02). In multivariate analysis, ipilimumab (p = 0.02) and diagnosis-specific graded prognostic assessment (p = 0.02) were associated with OS. There were no differences in intracranial control by ipilimumab administration or timing. The incidence of radiation necrosis was 5%, with most events occurring in patients who received ipilimumab.

conclusionsPatients who received ipilimumab had improved OS even after adjusting for prognostic factors. Ipilimumab did not appear to increase risk for acute toxicity. The majority of radiation necrosis events, however, occurred in patients who received ipilimumab. Our results support the continued use of SRS and ipilimumab as clinically appropriate.

Indexed as

RadiosurgeryAdultAgedAged, 80 and overAntineoplastic Agents, ImmunologicalBrain NeoplasmsChemoradiotherapyFemaleFollow-Up StudiesHumansIpilimumabMaleMelanomaMiddle AgedRetrospective StudiesSurvival AnalysisAntineoplastic Agents, ImmunologicalIpilimumabClinical outcomesIpilimumab immunotherapyMelanoma brain metastasesRadiation toxicityStereotactic radiosurgery

Identifiers

PMID29696531
PMCPMC7469981
OpenAlexW2802488938

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.