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Journal of Skin Cancer
Volume 2011, Article ID 845863, 6 pages
http://dx.doi.org/10.1155/2011/845863
Review Article

Management of Melanoma Brain Metastases in the Era of Targeted Therapy

1Section of Melanoma, Renal Cancer and Immunotherapy, Nevada Cancer Institute, One Breakthrough Way, Las Vegas, NV 89135, USA
2Comprehensive Cancer Centers of Nevada, Henderson, NV 89014, USA
3US Oncology Research Developmental Therapeutics and Genitourinary Committees, Woodloch, TX, USA
4University of Nevada, Reno, NV, USA

Received 16 February 2011; Accepted 7 November 2011

Academic Editor: John M. Kirkwood

Copyright © 2011 Daniela Gonsalves Shapiro and Wolfram E. Samlowski. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Disseminated metastatic disease, including brain metastases, is commonly encountered in malignant melanoma. The classical treatment approach for melanoma brain metastases has been neurosurgical resection followed by whole brain radiotherapy. Traditionally, if lesions were either too numerous or surgical intervention would cause substantial neurologic deficits, patients were either treated with whole brain radiotherapy or referred to hospice and supportive care. Chemotherapy has not proven effective in treating brain metastases. Improvements in surgery, radiosurgery, and new drug discoveries have provided a wider range of treatment options. Additionally, recently discovered mutations in the melanoma genome have led to the development of “targeted therapy.” These vastly improved options are resulting in novel treatment paradigms for approaching melanoma brain metastases in patients with and without systemic metastatic disease. It is therefore likely that improved survival can currently be achieved in at least a subset of melanoma patients with brain metastases.