In my experience, patients who have had symptomatic brain metastases can be safely treated with immunotherapy without any problems. 4,5 There was initially some concern that you would have some degree of pseudo-progression or immune infiltration into the brain that would cause more symptoms, I think that issue has been somewhat quelled now that we have more experience. Since then, we have learned from data both from melanoma and NSCLC that patients treated with immunotherapy can do well and have ongoing responses to the brain. SANTANA-DAVILA: The study only allowed patients with brain metastases who had previously been treated with radiation.
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