Objective:

To determine the frequency and timing of brain metastases and characterize the outcome of delayed brain metastases following initial ipilimumab-nivolumab therapy, distinguishing between initial and delayed occurrences.

Key Findings:

• 27.4% of patients developed brain metastases, with 19.2% at initial diagnosis; notably, most patients with brain metastases had a BRAF V600E mutation, indicating a potential target for therapy.

Interpretation:

The study highlights the evolving outcomes for metastatic melanoma patients with brain metastases treated with ipilimumab and nivolumab, indicating potential for improved survival and suggesting a need for tailored treatment strategies.

Limitations:

• Retrospective design may introduce bias; small sample size limits generalizability; potential confounding factors may affect outcomes.

Conclusion:

Ipilimumab plus nivolumab therapy may provide a favorable outcome for patients with delayed brain metastases, warranting further investigation and consideration for clinical practice.