Study identifies best imaging methods for evaluating brain tumor response in melanoma patients

Raymond Y. Huang, MD, Ph.D., of the Department of Radiology at Brigham and Women's Hospital, is the corresponding author of a paper published in the Journal of Clinical Oncology, "Comparative Analysis of Intracranial Response Assessment Criteria in Patients With Melanoma Brain Metastases Treated With Combination Nivolumab + Ipilimumab in CheckMate 204."

How would you summarize your study for a lay audience?

Our study examines how different imaging criteria can be used to assess brain tumor responses in patients with melanoma treated with immunotherapy drugs. We identified one imaging method that was more accurate in predicting survival compared to others. While further work is needed, our study is promising and highlights the importance of more consistent imaging standards in clinical trials.

What methods or approach did you use?

We looked at different measurements of brain metastases (tumors that form when cancer cells spread to the brain) on MRI scans taken over the course of two years or longer for patients in a multi-center phase 2 clinical trial evaluating an immunotherapy for brain cancer. We took into consideration the patient's response to the therapy, including progression-free survival (PFS) and overall survival (OS), to determine which set of criteria was most predictive of patient outcome.

What did you find?

We found that a modified imaging approach (mRECIST) and volumetric measurements (3D size analysis) were more accurate in predicting survival compared to other methods. These approaches worked well even for small tumors, suggesting they should be included in future studies when evaluating treatment response.

What are the implications?

Overall, these findings aim to improve how oncologists evaluate and treat brain metastases in cancer patients.

What are the next steps?

 We are currently developing automatic segmentation technology to improve the consistency of 3D tumor measurements, with the goal of making a standard tool for evaluating brain metastases.