Onkológia 4/2025
Comprehensive management of patients with BRAF-mutated malignant melanoma with brain metastases
The presence of brain metastases in malignant melanoma is a negative prognostic factor. Management of these patients today requires a multidisciplinary approach. Risk factors associated with a higher risk of brain metastases include the presence of a BRAF mutation. treatment modality depends on several factors, including the patient›s performance status, clinical symptomatology, eligibility for treatment, size and number of brain metastases, extent of extracranial disease, and patient preference. The use of systemic therapy , whether immunotherapy (IO) or targeted therapy, has become the standard of care. In today›s clinical practice, most patients with asymptomatic CNS metastases are treated initially with systemic therapy. Standard brain-targeted therapies such as neurosurgical resection, stereotactic radiosurgery (SRS) and whole brain radiotherapy (WBRT) are also commonly used. However, the heterogeneity of tumors and the tumor microenvironment can often hinder their efficacy. Determining the optimal treatment approach for brain metastases remains one of the most debated issues.
Keywords: malignant melanoma, brain metastasis, imunotherapy, target treatment, stereotactic radiosurgery
