ArticlePigment cell & melanoma research2019
Incidence, features and management of radionecrosis in melanoma patients treated with cerebral radiotherapy and anti-PD-1 antibodies.
Article in Pigment cell & melanoma research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Immune checkpoint inhibitor therapy may increase the incidence of treatment-related necrosis after stereotactic radiosurgery for brain metastases: a systematic review and meta-analysis.European radiology · 2021Pooled it
- Quantification of Scheduling Impact on Safety and Efficacy Outcomes of Brain Metastasis Radio- and Immuno-Therapies: A Systematic Review and Meta-Analysis.Frontiers in oncology · 2020Pooled it
- Outcomes of concurrent versus non-concurrent immune checkpoint inhibition with stereotactic radiosurgery for melanoma brain metastases.Journal of neuro-oncology · 2025Article
- Whole brain radiation therapy resulting in radionecrosis: a possible link with radiosensitising chemoimmunotherapy.BMJ case reports · 2023Article
- Radionecrosis mimicking pseudo‑progression in a patient with lung cancer and brain metastasis following the combination of anti‑PD‑1 therapy and stereotactic radiosurgery: A case report.Oncology letters · 2023Article
- Low-Dose Bevacizumab for the Treatment of Focal Radiation Necrosis of the Brain (fRNB): A Single-Center Case Series.Cancers · 2023Article
- Impressive reduction of brain metastasis radionecrosis after cabozantinib therapy in metastatic renal carcinoma: A case report and review of the literature.Frontiers in oncology · 2023Article
- Risk of radiation necrosis after stereotactic radiosurgery for melanoma brain metastasis by anatomical location.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Article
- Safety and efficacy of the combination of nivolumab plus ipilimumab in patients with melanoma and asymptomatic or symptomatic brain metastases (CheckMate 204).Neuro-oncology · 2021Article
- Immunotherapy use outside clinical trial populations: never say never?Annals of oncology : official journal of the European Society for Medical Oncology · 2021Review
- Examining the relationship of immunotherapy and wound complications following flap reconstruction in patients with head and neck cancer.Head & neck · 2021Article
- A Multicenter Analysis of Immune Checkpoint Inhibitors as Adjuvant Therapy Following Treatment of Isolated Brain Metastasis.The oncologist · 2021Article
- Volume of Disease as a Predictor for Clinical Outcomes in Patients With Melanoma Brain Metastases Treated With Stereotactic Radiosurgery and Immune Checkpoint Therapy.Frontiers in oncology · 2021Article
- Survivorship in immune therapy: Assessing toxicities, body composition and health-related quality of life among long-term survivors treated with antibodies to programmed death-1 receptor and its ligand.European journal of cancer (Oxford, England : 1990) · 2020Article
- Imaging challenges of immunotherapy and targeted therapy in patients with brain metastases: response, progression, and pseudoprogression.Neuro-oncology · 2020Review
- Extent of surrounding edema does not correlate with acute complications after radiosurgery for melanoma brain metastases.Journal of neuro-oncology · 2019Article
- Immunotherapy of brain metastases: breaking a "dogma".Journal of experimental & clinical cancer research : CR · 2019Review
Corrections and comments
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Authors and funding
25 authors at 12 institutions in 4 countries.
Funding
Abstract
backgroundBrain radiotherapy is used in the management of melanoma brain metastases (MBM) and can result in radionecrosis. Anti-PD-1 is active in the brain and may increase the risk of radionecrosis when combined with radiotherapy. We studied the incidence, associated factors and management of radionecrosis in longer-term survivors with MBM treated with this combination.
methodsPatients with MBM treated with radiotherapy and anti-PD-1 who survived >1 year were identified to determine radionecrosis incidence (Cohort A, n = 135). Cohort A plus additional radionecrosis cases were examined for factors associated with radionecrosis and management (Cohort B, n = 148).
resultsFrom Cohort A, 17% developed radionecrosis, with a cumulative incidence at 2 years of 18%. Using Cohort B, multivariable analysis confirmed an association between radionecrosis and elevated lactate dehydrogenase (p = 0.0496) and prior treatment with ipilimumab (p = 0.0319). Radionecrosis was diagnosed based on MRI (100%), symptoms (69%) and pathology (56%). Treatment included corticosteroids, bevacizumab and neurosurgery.
conclusionsRadionecrosis is a significant toxicity in longer-term melanoma survivors with MBM treated with anti-PD-1 and radiotherapy. Identification of those at risk of radionecrosis who may avoid radiotherapy is required.
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