Another retrospective series of 137 patients with melanoma brain metastases identified 37 patients (27%) who developed radionecrosis following SRS or WBRT and anti-CTLA-4 or anti-PD-1 therapy with a median time of onset of 6 months (range 1.3–31.4 months), which is comparable to rates seen in other series though prospective studies are limited [129–132]. This evidence concerns the gene CTLA4 and melanoma.