How do you decide between initial radiotherapy vs systemic therapy in patients with metastatic melanoma and brain metastases?
If neurologic symptoms are absent or controlled, does that affect your treatment decision?
Answer from: Medical Oncologist at Academic Institution
An interesting question the answer to which is changing!For discussion we will assume that the patient is not previously treated. Presence or absence of CNS symptoms is likely the most important way to dichotomize these patients. Other issues include number and size of the brain metastases, whether ...
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Answer from: Radiation Oncologist at Academic Institution
I have seen excellent responses to BRAF inhibitors in BRAF+ patients. One patient with diffuse leptomeningeal disease had a memorable objective and subjective response within days.