Severe Radiation Necrosis Refractory to Surgical Resection in Patients with Melanoma and Brain Metastases Managed with Ipilimumab/Nivolumab and Brain-Directed Stereotactic Radiation Therapy

The use of targeted therapies and immune checkpoint inhibitors has drastically changed the management of patients with melanoma and brain metastases. Specifically, combination therapy with ipilimumab, a cytotoxic T-lymphocyte antigen 4 inhibitor, and nivolumab, a programmed cell death protein 1 inhibitor, has become a preferred systemic therapy option for patients with melanoma and asymptomatic brain metastases. However, the efficacy and...