Benefits of screening and monitoring brain MRIs in patients with metastatic melanoma

This article was originally published here

Cancer Med. November 5, 2021. doi: 10.1002 / cam4.4342. Online ahead of print.

ABSTRACT

BACKGROUND: New treatments provide long-term survival for subgroups of patients with melanoma brain metastases. Brain magnetic resonance imaging (MRI) can help in the early detection of brain metastases and inform treatment decisions. This study aimed to determine the impact of MRI screening in patients with metastatic melanoma and follow-up MRI in patients with brain metastases from melanoma.

Methods: This retrospective cohort study included patients diagnosed with metastatic melanoma or melanoma brain metastases between June 2015 and January 2018. The impact of MRI screening was assessed during the first 2 years after the diagnosis of melanoma. metastatic. The impact of follow-up MRI scans was examined during the first year after the diagnosis of brain metastases. The number of MRI scans, examination indications, examination results and changes in treatment strategy were analyzed.

RESULTS: A total of 116 patients had no brain metastases at the time of diagnosis of metastatic melanoma. Twenty-eight of these patients (24%) were subsequently diagnosed with brain metastases. Screening MRI detected brain metastases in 11/28 patients (39%), 8 of whom were asymptomatic at diagnosis. In the 96 patients with melanoma brain metastases, the treatment strategy changed after 75/168 follow-up MRI (45%). In patients treated with immune checkpoint inhibitors, the number of treatment changes after follow-up MRIs was lower when the patients were treated longer.

CONCLUSION (S): Screening MRIs help in the early detection of melanoma brain metastases, and follow-up MRIs inform treatment strategy. In patients with brain metastases responding to immune checkpoint inhibitors, treatment changes were less frequently seen after follow-up MRIs. These findings may inform the development of brain imaging protocols for patients with tumors sensitive to immune checkpoint inhibitors.

PMID:34741440 | DO I:10.1002 / cam4.4342

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