Checkpoint inhibitors in the treatment of brain metastases of non-small-cell lung cancer and melanoma.

Brain metastases (BMs) are representing a new challenge for the oncologist; their incidence is increasing due to the better overall survival and systemic disease control in many malignancies, consequent to new potent cytotoxic and targeted therapies. In the era of immunotherapies, checkpoint inhibitors are representing a new therapeutic option in different solid tumors and settings; preliminary results showed potential activity of these agents in patients with BM, when administered as single agent or in combination with radiation therapy. After presenting the arguments in favor of this new strategy, we reported the preliminary results of the trials evaluating these agents in BM, we described the ongoing trials and we discussed the potential role of these agents in the BM treatment.

Intravitreal methotrexate in vemurafenib-induced uveitis.

PURPOSE: Vemurafenib, a BRAF inhibitor, has revolutionized the prognosis of late-stage melanoma patients, rising at the same time concerns about its potential adverse effects. Here is a case of vemurafenib-induced uveitis, peculiar in both its presentation and management. METHODS: Case report, diagnostic and therapeutic challenge. RESULTS: Uveitis is a known side effect of vemurafenib. It is generally bilateral, moderate, manageable with topical steroids and does not require cancer therapy cessation. We present a patient who suffered from a unilateral, severe uveitis following vemurafenib treatment that fully recovered thanks to intravitreal methotrexate injections, as conventional corticosteroid therapy was contraindicated. CONCLUSION: Uveitis can be a serious ocular adverse effect of vemurafenib, while its risks factors and mechanisms remain unknown. As BRAF inhibitors are now used on a regular basis, it is important for clinicians to be aware of this potentially sight-threatening side effect. Intravitreal methotrexate injections may be considered as an effective treatment choice in severe targeted agents-induced uveitis.

Learning from the "tsunami" of immune checkpoint inhibitors in 2015.

2015 was marked by the tsunami of immune checkpoint inhibitors revealed by numerous FDA approvals, publications and abstracts in relation with these drugs in different cancers and settings. First, we reported all new indications of anti-CTLA4 and anti-PD1 approved by the FDA, the positive clinical trials published and the abstracts with promising results at important scientific meetings during 2015. Then, we discussed different critical issues of these new agents going from their predictive factors, combination therapies, tumor response patterns, efficacy in particular settings, side effect management to cost and economic burden.