Brain Metastases in Patients With Metastatic Uveal Melanoma

A group of researchers sought out to determine the incidence of brain metastases and its true rate of occurrence in patients with metastatic uveal melanoma (mUM).

For their research, Wei and colleagues conducted a multicenter, retrospective study to clarify the clinical and genomic risk factors associated with patients with brain metastases. In total, data was collected from 1845 patients with mUM where the researchers, through analysis, identified patients with brain metastases. In most cases, brain imaging was performed due to neurological symptoms and not for routine surveillance of disease.

The researchers identified 116 (6.3%) patients with brain metastases out of the total, with a median age at the time of uveal melanoma diagnosis of 54 years old. According to their data, the most common initial metastatic site was the liver (75.9%). Of the 116 patients with mUM and brain metastases 15 (12.9%) presented with brain metastases at the time of an initial metastatic diagnosis. When patients were diagnosed with brain metastases, the average survival rate was 7.6 months after diagnosis.

“Brain metastases in uveal melanoma are not rare despite prior beliefs. Although no patients in our cohort were diagnosed with brain metastases on initial primary diagnosis, 6.3% of patients with mUM ultimately developed brain metastases,” the researchers wrote.

Further, because of their findings, the researchers suggested the use of routine brain imaging in all patients with mUM who may be at risk for developing brain metastases, particularly those with “with late stages of disease, including three or more visceral metastases, a mUM diagnosis over 14 months prior, or treatment failure after three systemic lines of therapy.”  The use of brain imaging will allow for early detection.

“Given our finding that brain metastases in uveal melanoma is not uncommon, with 6.3% of patients with mUM developing brain metastases and 12.9% of those patients presenting with symptomatic brain metastases at time of metastatic diagnosis, an argument can be made to recommend routine surveillance brain imaging for all patients with uveal melanoma at the time of initial metastatic diagnosis and at periodic intervals subsequently,” the researchers concluded.

Reference:

Wei AZ, Uriel M, Porcu A, et al. Characterizing metastatic uveal melanoma patients who develop symptomatic brain metastases. Front Oncol. Published online September 8, 2022. doi:10.3389/fonc.2022.961517