Prognostic Factors for Survival in Melanoma Patients with Brain Metastases

Melanoma is the most aggressive form of skin cancer. One of the most common and devastating complications of advanced melanoma is the development of metastases to the central nervous system (CNS). Historically outcomes in patients with melanoma brain metastases have been dismal. However, an improved understanding of the molecular pathogenesis of this disease has recently led to the development of multiple new therapies with unprecedented clinical efficacy, generating optimism that significant improvements in long-term patient survival are achievable. Achieving this goal will require improved prevention and treatment of CNS metastases. To set the stage for the appropriate design and interpretation of clinical trials in this area, this chapter will review and integrate existing data about clinical and molecular factors that predict the development, survival, and treatment outcomes of melanoma patients with brain metastases.