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Du Four S, Hong A, Chan M, et al. Symptomatic Histologically Proven Necrosis of Brain following Stereotactic Radiation and Ipilimumab in Six Lesions in Four Melanoma Patients. Case Rep Oncol Med. 2014;2014:417913doi: 10.1155/2014/417913.
Du Four, S., Hong, A., Chan, M., Charakidis, M., Duerinck, J., Wilgenhof, S., Wang, W., Feng, L., Michotte, A., Okera, M., Shivalingam, B., Fogarty, G., Kefford, R., & Neyns, B. (2014). Symptomatic Histologically Proven Necrosis of Brain following Stereotactic Radiation and Ipilimumab in Six Lesions in Four Melanoma Patients. Case reports in oncological medicine, 2014417913. https://doi.org/10.1155/2014/417913
Du Four, Stephanie, et al. "Symptomatic Histologically Proven Necrosis of Brain following Stereotactic Radiation and Ipilimumab in Six Lesions in Four Melanoma Patients." Case reports in oncological medicine vol. 2014 (2014): 417913. doi: https://doi.org/10.1155/2014/417913
Du Four S, Hong A, Chan M, Charakidis M, Duerinck J, Wilgenhof S, Wang W, Feng L, Michotte A, Okera M, Shivalingam B, Fogarty G, Kefford R, Neyns B. Symptomatic Histologically Proven Necrosis of Brain following Stereotactic Radiation and Ipilimumab in Six Lesions in Four Melanoma Patients. Case Rep Oncol Med. 2014;2014:417913. doi: 10.1155/2014/417913. Epub 2014 Jul 01. PMID: 25105043; PMCID: PMC4102092.
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Case Rep Oncol Med. 2014;2014:417913. doi: 10.1155/2014/417913. Epub 2014 Jul 01.

Symptomatic Histologically Proven Necrosis of Brain following Stereotactic Radiation and Ipilimumab in Six Lesions in Four Melanoma Patients.

Case reports in oncological medicine

Stephanie Du Four, Angela Hong, Matthew Chan, Michail Charakidis, Johnny Duerinck, Sofie Wilgenhof, Wei Wang, Linda Feng, Alex Michotte, Meena Okera, Brindha Shivalingam, Gerald Fogarty, Richard Kefford, Bart Neyns

Affiliations

  1. Neurosurgery, UZ Brussel, Campus Jette, Laarbeeklaan 101, 1090 Brussels, Belgium ; Medical Oncology, UZ Brussel, Campus Jette, Laarbeeklaan 101, 1090 Brussels, Belgium.
  2. Melanoma Institute Australia, Poche Centre, 40 Rocklands Road, Sydney, NSW 2060, Australia.
  3. Crown Princess Mary Cancer Centre Westmead, University of Sydney, Sydney, NSW 2060, Australia.
  4. Medical Oncology, Royal Darwin Hospital, 105 Rocklands Drive, Tiwi, Darwin, NT 0810, Australia.
  5. Neurosurgery, UZ Brussel, Campus Jette, Laarbeeklaan 101, 1090 Brussels, Belgium.
  6. Medical Oncology, UZ Brussel, Campus Jette, Laarbeeklaan 101, 1090 Brussels, Belgium.
  7. Radiation Oncology, University of Sydney, Edward Ford Building, Physics Road, Camperdown, Sydney, NSW 2006, Australia.
  8. Westmead Clinical School, University of Sydney, Cnr Hawkesbury Road & Darcy Road, Westmead, NSW 2145, Australia.
  9. Neuropathology, UZ Brussel, Campus Jette, Laarbeeklaan 101, 1090 Brussels, Belgium.
  10. Department of Neurosurgery, Mater Hospital, 25 Rocklands Road, Crows Nest, NSW 2060, Australia.
  11. Department of Radiation Oncology, Mater Hospital, 25 Rocklands Road, Crows Nest, NSW 2060, Australia.

PMID: 25105043 PMCID: PMC4102092 DOI: 10.1155/2014/417913

Abstract

Four cases previously treated with ipilimumab with a total of six histologically confirmed symptomatic lesions of RNB without any sign of active tumour following stereotactic irradiation of MBM are reported. These lesions were all originally thought to be disease recurrence. In two cases, ipilimumab was given prior to SRT; in the other two ipilimumab was given after SRT. The average time from first ipilimumab to RNB was 15 months. The average time from SRT to RNB was 11 months. The average time from first diagnosis of MBM to last follow-up was 20 months at which time three patients were still alive, one with no evidence of disease. These cases represent approximately three percent of the total cases of melanoma and ten percent of those cases treated with ipilimumab irradiated in our respective centres collectively. We report this to highlight this new problem so that others may have a high index of suspicion, allowing, if clinically warranted, aggressive surgical salvage, possibly resulting in increased survival. Further studies prospectively collecting data to understand the denominator of this problem are needed to determine whether this problem is just the result of longer survival or whether there is some synergy between these two modalities that are increasingly being used together.

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