Melanoma's deadly march to the brain: by what route, and can it be stopped?

Abstract

Melanoma patients who develop brain metastasis have a very poor prognosis, in part because of relative resistance to external beam radiotherapy and in part due to the low activity and poor CNS penetration of the available systemic agents. Three articles in this issue of Cancer summarize retrospective analyses of melanoma patients with brain metastasis. While the three articles investigate similar questions, each article considers different patient characteristics, and the results of the articles provide different and diverging conclusions. We will summarize the results and authors’ conclusions from each of the three articles, examine potential limitations of each article’s conclusions, try to synthesize the results of the three articles, and conclude with ideas for future research.