Development of brain metastases in patients with metastatic melanoma treated with ipilimumab plus temozolomide.

e19014 Background: Melanoma has a high predilection for brain metastasis (BM), and despite treatment, survival is often 3 to 6 months. There have been a number of reports of disease regression in BM with each Ipilimumab (Ipi), an anti-CTLA 4 antibody, and temozolomide (Tem), an alkylating drug capable of crossing the blood-brain barrier, in patients with metastatic melanoma (MM). Previous Ipi trials excluded patients with BM. Previous Tem trials have BM incidence ranging from 20 to 36%. Here we describe our experience with the combination of Ipi+Tem and BM. Methods: Patients (pts) are from a 64-patient cohort with unresectable Stage III or Stage IV metastatic melanoma enrolled in a single-center Phase II trial of Ipi+Tem. Induction phase consisted of Ipi 10mg/kg intravenous (IV) on Day 1 and oral Tem 200mg/m2 Days 1-4 every 3 weeks for 4 courses. Maintenance phase was Ipi 10mg/kg IV every 12 weeks and oral Tem 200mg/m2 on Days 1-5 every 4 weeks. Brain MRI was obtained every 2 cycles as part of the protoco...