Complete Response of Multiple Melanoma Brain Metastases after Treatment with Temozolomide

Dvořák, Josef; Melichar, Bohuslav; Žižka, Ján; D, Hadži-Nikolov; Petera, J

doi:10.1159/000076908

Cited by 9 publications

(3 citation statements)

References 26 publications

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“…Temozolomide (TMZ) is an alkylating agent that crosses the blood-brain barrier and has produced clinical responses in some patients with melanoma brain metasta-ses. [22][23][24] In this study, patients who received TMZ as the initial therapy for their brain metastases (n ¼ 7) had a median OS of 4.70 months, which did not differ significantly from that of patients receiving any other systemic therapy as their initial treatment (n ¼ 50; median OS, 4.67 months [P ¼ .55]). Patients who received TMZ (n ¼ 24) at any time after the diagnosis of brain metastases demonstrated a trend toward longer survival than patients who received other systemic therapies (n ¼ 134) (median OS, 7.79 months vs 6.92 months; P ¼ .07 by the log-rank test) ( Fig.…”

Section: Resultsmentioning

confidence: 73%

“…Temozolomide (TMZ) is an alkylating agent that crosses the blood‐brain barrier and has produced clinical responses in some patients with melanoma brain metastases 22‐24. In this study, patients who received TMZ as the initial therapy for their brain metastases (n = 7) had a median OS of 4.70 months, which did not differ significantly from that of patients receiving any other systemic therapy as their initial treatment (n = 50; median OS, 4.67 months [ P = .55]).…”

Section: Resultsmentioning

confidence: 87%

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Prognostic factors for survival in melanoma patients with brain metastases

Davies

Liu

McIntyre

et al. 2010

Cancer

466

358

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BACKGROUND:One of the most common and deadly complications of melanoma is brain metastases. The outcomes of advanced melanoma patients who developed brain metastases were reviewed to identify significant prognostic factors for overall survival (OS). METHODS: An institutional database of advanced melanoma patients enrolled on clinical trials in the Department of Melanoma Medical Oncology from 1986 to 2004 was reviewed and patients who developed brain metastases were identified. Date of diagnosis, patient age, pattern of brain involvement, timing relative to extracranial metastases, prior response to systemic therapy, and treatments given for brain metastases were assessed as potential prognostic factors for OS. RESULTS: Among 743 melanoma patients enrolled in clinical trials for regional or systemic metastatic disease, 330 (44%) patients developed brain metastases. The median OS after the diagnosis of brain metastases was 4.7 months. Diagnosis before 1996, increased number of parenchymal brain metastases, leptomeningeal involvement, and development of brain metastases after receiving systemic therapy for extracranial metastases were found to be significant prognostic factors for OS. Among patients who received systemic therapy as the initial treatment of brain metastases, patients who previously responded to systemic therapies had longer survival than patients who had not responded. CONCLUSIONS: The era, pattern, and timing of melanoma brain metastases were found to be strongly associated with survival. Previous responsiveness to systemic therapies did not predict better outcomes overall, but it did correlate with improved survival for patients with brain metastases who were treated with systemic therapies. These factors may be used in guiding patient management and for stratifying patients in clinical trials. Cancer 2011;117:1687-96.

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Section: Resultsmentioning

confidence: 73%

Section: Resultsmentioning

confidence: 87%

Prognostic factors for survival in melanoma patients with brain metastases

Davies

Liu

McIntyre

et al. 2010

Cancer

466

358

View full text Add to dashboard Cite

show abstract

“…In der gleichen Beobachtungsstudie zeigten 2 Fälle eine komplette Remission der Hirnfiliae nach Temozolomid-Therapie [9]. 2004 wurde ebenfalls über eine komplette Remission bei einer Patientin mit Hirnmetastasen berichtet, die mit 6 Zyklen Temozolomid (300 mg täglich über 5 Tage) behandelt wurde [10]. Eine Kombination aus Radiochemotherapie und Temozolomid bietet einen vielversprechenden Therapieansatz.…”

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60 Monate Gesamtüberleben bei Hirnmetastasen eines Melanoms - in der Schwangerschaft diagnostiziert

Crößmann

Bayerl

2013

Akt Dermatol

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Zusammenfassung Einleitung: Liegt bei einer schwangeren Patientin die Diagnose Malignes Melanom vor, so sind viele Entscheidungen erforderlich. Im Folgenden wird ?ber eine schwangere Melanompatientin berichtet, bei der eine Kombinationstherapie aus Radiatio und Zytostatikum erst nach Entbindung eingeleitet wurde; mit einer erstaunlichen ?berlebenszeit. Fallbericht: Eine damals 23-j?hrige, in der 20.?Woche schwangere Patientin stellt sich im Juni 2007 in der Hautklinik Wiesbaden mit einem ulzerierten Malignen Melanom mit Lymphangiosis melanomatosa (Tumordicke 3,8?mm, Clark-Level IV) im Bereich der rechten Schulter vor. Die Patientin entschied sich f?r eine schwangerschaftserhaltende Diagnostik und zur?ckhaltende Therapie. Nach Entbindung (Dezember 2007) wurde das Staging komplettiert. Im MRT-Sch?del wurden drei rechtshemisph?rische Hirnmetastasen diagnostiziert. Therapie und Verlauf: Nach Entbindung wurde bei der Patientin eine Kombination aus Gamma-Knife-Therapie (3 Zyklen) und Temozolomid (8 Zyklen) durchgef?hrt. Die Hirnfiliae haben sich bis auf eine gr??enkonstante solit?re Filia rechts frontal kortikal zur?ckgebildet. Diskussion: Zur Behandlung von Hirnmetastasen stehen unterschiedliche Therapiem?glichkeiten zur Verf?gung. Eine Kombination aus Gamma-Knife-Therapie und Temozolomid bietet einen vielversprechenden Therapieansatz, denn Temozolomid wirkt auch als Strahlensensitizer. In einer von Antonadou 2002 durchgef?hrten Studie f?hrte solch eine Kombinationsbehandlung zu einer Erh?hung der Ansprechrate von 67?% mit alleiniger Strahlentherapie auf 96?%. In dem hier vorgestellten Fall wurde die Gesamt?berlebenszeit des Patienten trotz Latenz bis zu Therapiebeginn abweichend von der bisherigen Literatur auf bisher 5 Jahre verl?ngert. M?glicherweise basiert diese lange ?berlebenszeit aus dem synergistischen Effekt aus Radiotherapie und Chemotherapie.

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Neurologic Complications of Melanoma

Damek¹

Cancer Neurology in Clinical Practice

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Complete Response of Multiple Melanoma Brain Metastases after Treatment with Temozolomide

Cited by 9 publications

References 26 publications

Prognostic factors for survival in melanoma patients with brain metastases

Prognostic factors for survival in melanoma patients with brain metastases

60 Monate Gesamtüberleben bei Hirnmetastasen eines Melanoms - in der Schwangerschaft diagnostiziert

Neurologic Complications of Melanoma

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