Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Department of Internal Medicine, Division of Hematology/Oncology, University of Virginia Cancer Center, Charlottesville, VA, USA.
Cancer Invest. 2024 May;42(5):400-407. doi: 10.1080/07357907.2024.2354809. Epub 2024 May 22.
The CNS is a common site for distant metastasis and treatment failure in melanoma patients. This study aimed to evaluate the inclusion rate of patients with melanoma brain metastases (MBM) in prospective clinical trials. 69.3% of trials excluded MBM patients based on their CNS disease. In univariate analysis, trials not employing immunotherapy ( = 0.0174), inclusion of leptomeningeal disease ( < 0.0001) and non-pharmaceutical sponsor trials ( = 0.0461) were more likely to enroll patients with MBM. Thoughtful reconsideration of clinical trial designs is needed to give patients with MBMs access to promising investigational agents and improve outcomes for patients with MBM.
中枢神经系统是黑色素瘤患者远处转移和治疗失败的常见部位。本研究旨在评估前瞻性临床试验中黑色素瘤脑转移(MBM)患者的纳入率。69.3%的试验基于中枢神经系统疾病排除了 MBM 患者。单因素分析显示,未使用免疫疗法的试验( = 0.0174)、包含软脑膜疾病的试验( < 0.0001)和非制药赞助商试验( = 0.0461)更有可能纳入 MBM 患者。需要对临床试验设计进行深思熟虑的重新考虑,以使 MBM 患者能够获得有前途的研究药物,并改善 MBM 患者的结局。