Would you consider starting immunotherapy concurrently with whole brain radiation for newly diagnosed metastatic (BRAF negative) melanoma with multifocal symptomatic brain metastases?
If so, would you consider it with monotherapy only or also with combined checkpoint blockade?
Answer from: Medical Oncologist at Academic Institution
This is a challenging clinical situation. In part, the approach depends on the number and size of the CNS lesions. However, I do not recommend the use of WBRT for my patients, as it has not demonstrated a survival benefit. In addition, in the adjuvant trial comparing WBRT to observation, it did not ...
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Answer from: Medical Oncologist at Academic Institution
Generally I would agree with @Theresa Medina about the treatment of patients with BRAF wild type melanoma and brain metastases who do not require steroids or can be weaned quickly from them. I am not aware of data about concurrent use of immunotherapy (IO) and whole brain radiation therapy (WBXRT) t...