How do you approach an elderly patient (~80 years) with stage IIC melanoma post resection with oligometastatic brain lesion post intracranial resection which developed 2 years after treatment?
The patient's current PET scan showed no systemic disease. Due to his age, there is a concern of whether the patient would tolerate dual immunotherapy. He prefers quality of life. Would this patient benefit from cyber-knife versus systemic therapy (CheckMate 204) versus observation?
Answer from: Medical Oncologist at Academic Institution
If I am understanding this correctly, then all known metastatic recurrence has been resected.In that case, I recommend cyberknife/SRS to the surgical cavity followed by single agent anti-PD1 therapy. Concurrent administration of anti-PD1 with SRS or GKRS is experimental at this point. There is no co...
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Answer from: Radiation Oncologist at Academic Institution
SRS if feasible re size and location.