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How do you approach hemorrhagic brain metastases in melanoma?
Are there scenarios where one would rely on dual agent immunotherapy alone? Or would one generally err on the side of utilizing some form of metastasis-directed local therapy where feasible (surgery and/or radiation) to gain CNS control?
Answer from: Medical Oncologist at Academic Institution
This is a symptomatic brain metastasis from melanoma. Such patients had poor outcomes in the CheckMate 204 trial with dual IO therapy alone. Local control with RT therapy is advised. In our practice, we start with IO-therapy and radiation joins in whenever they are ready with the plan (as GKRS plan ...
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