Novel treatments for melanoma over the past decade have dramatically enhanced survival. Immune checkpoint inhibitors and BRAF/MEK inhibitors have both demonstrated significant improvements in melanoma patient outcomes as demonstrated by many clinical trials. Unfortunately, patients who develop brain metastases still carry a grim prognosis, with a median overall survival of fewer than 6 months. Additionally, there is relatively little guidance in the literature comparing different therapies for brain metastases in melanoma to assist oncologists with developing a treatment plan for these patients.
During his second year of residency, PGY-3 resident John Rieth, MD, evaluated 209 cases of melanoma brain metastases and assessed the overall survival of this patient population. Specifically, he evaluated different treatments, including systemic treatments, radiation therapies, and surgical resection, and analyzed these treatments for both survival and progression of disease in this cohort.
With the mentorship of Mohammed Milhem, MBBS, Rieth and colleagues published a study in Cancers that identified an association between surgical resection and CTLA-4 immunity checkpoint inhibitor therapy and improved survival rates, while whole brain radiation was associated with poorer overall survival.
“John is a rising star and is a joy to work with,” Milhem said. “He single-handedly put this together collaborating with all the different groups to get the data.”
Rieth was just as quick to return the compliment. “Mo is a wonderful mentor, both in the clinic and as a researcher. His mentorship, advocacy, and teaching has helped me to develop into the aspiring oncologist that I am today.”
Researchers from five departments within the Carver College of Medicine contributed to the study design and data acquisition. Authors on the publication include Milhem, Umang Swami, MD; Sarah Mott, MS; Mario Zanaty, MD; Michael Henry, PhD; Aaron Bossler, MD, PhD; Jeremy Greenlee, MD; Yousef Zakharia, MD; and Marion Vanneste, PhD.
Additionally, Rieth offered his own mentoring to a medical student Brooke Jennings, who also contributed to the publication.
“Brooke is an impressive medical student, and will make both an excellent internal medicine resident and future oncologist,” Rieth said. “She not only assisted me with this project, but we are also collaborating on multiple scientific projects and case reports. She is an incredibly hard worker, and she has a bright future.”
Rieth has a passion for mentoring, working with Jennings for the past two years. For one month this year, Rieth was also selected to be a teaching resident.