ArticleOncoimmunology2022
Evaluation of radio-immunotherapy sequence on immunological responses and clinical outcomes in patients with melanoma brain metastases (ELEKTRA).
Article in Oncoimmunology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Improved survival outcome with not-delayed radiotherapy and immediate PD-1/PD-L1 inhibitor for non-small-cell lung cancer patients with brain metastases.Journal of neuro-oncology · 2023Pooled it
- From DNA damage to systemic immunity: Interaction networks in radio-immunotherapy.Cell insight · 2026Review
- Remodeling memory T cells with chemotherapy and immune checkpoint inhibitors as host pre-conditioning to empower in vivo CAR-T therapy.Synthetic and systems biotechnology · 2026Review
- Review
- Synergy of radiotherapy, focused ultrasound, and immunotherapy in the treatment of brain metastases.Journal of neuro-oncology · 2025Review
- The Role of Immune Checkpoint Inhibitors in Cancer Therapy: Mechanism and Therapeutic Advances.MedComm · 2025Review
- Treatment patterns and outcomes in melanoma brain metastasis: exploring immune-related adverse events and survival.Immunotherapy · 2025Article
- Impact of Timing the Combination of Radiotherapy and PD-1 Inhibitors on Outcomes in Patients with Hepatocellular Carcinoma.Journal of hepatocellular carcinoma · 2025Article
- Immune Checkpoint Inhibitors and Glioblastoma: A Review on Current State and Future Directions.Journal of immunotherapy and precision oncology · 2024Article
- Neoadjuvant Chemoradiotherapy Upregulates the Immunogenicity of Cold to Hot Tumors in Esophageal Cancer Patients.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Trial watch: local anesthetics in cancer therapy.Oncoimmunology · 2024Article
- Progress in immunotherapy for brain metastatic melanoma.Frontiers in oncology · 2024Review
- Enhancing radiotherapy for melanoma: the promise of high-Z metal nanoparticles in radiosensitization.Nanomedicine (London, England) · 2024Review
- The role of tissue-resident memory T cells as mediators for response and toxicity in immunotherapy-treated melanoma-two sides of the same coin?Frontiers in immunology · 2024Review
- Immunotherapy: an emerging modality to checkmate brain metastasis.Molecular cancer · 2023Review
- Rapid disease progression on immune checkpoint inhibitors in young patients with stage IV melanoma.Frontiers in medicine · 2023Article
- Optimizing the synergy between stereotactic radiosurgery and immunotherapy for brain metastases.Frontiers in oncology · 2023Review
- Combination of immune checkpoint inhibitors with radiation therapy in cancer: A hammer breaking the wall of resistance.Frontiers in oncology · 2022Review
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In patients with melanoma brain metastases (MBM), a combination of radiotherapy (RT) with immune checkpoint inhibitors (ICI) is routinely used. However, the best sequence of radio-immunotherapy (RIT) remains unclear. In an exploratory phase 2 trial, MBM patients received RT (stereotactic or whole-brain radiotherapy depending on the number of MBM) combined with ipilimumab (ipi) ± nivolumab (nivo) in different sequencing (Rad-ICI or ICI-Rad). Comparators arms included patients treated with ipi-free systemic treatment or without RT (in MBM-free patients). The primary endpoints were radiological and immunological responses in the peripheral blood. Secondary endpoints were progression-free survival (PFS) and overall survival (OS). Of 106 screened, 92 patients were included in the study. Multivariate analysis revealed an advantage for patients starting with RT (Rad-ICI) for overall response rate (RR: p = .007; HR: 7.88 (95%CI: 1.76-35.27)) and disease control rate (DCR: p = .036; HR: 6.26 (95%CI: 1.13-34.71)) with a trend for a better PFS (p = .162; HR: 1.64 (95%CI: 0.8-3.3)). After RT plus two cycles of ipi-based ICI in both RIT sequences, increased frequencies of activated CD4, CD8 T cells and an increase in melanoma-specific T cell responses were observed in the peripheral blood. Lasso regression analysis revealed a significant clinical benefit for patients treated with Rad-ICI sequence and immunological features, including high frequencies of memory T cells and activated CD8 T cells in the blood. This study supports increasing evidence that sequencing RT followed by ICI treatment may have better effects on the immunological responses and clinical outcomes in MBM patients.
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