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Treatment for BRAF-Mutated Advanced Melanoma
The outcomes of a five-year trial investigating the efficacy and safety of the combination of a BRAF inhibitor and a MEK inhibitor treatment for advanced melanoma were recently presented at the Annual Meeting of the American Society of Clinical Oncology in Chicago.
Around 40 percent of patients with advanced melanoma have BRAF-mutations. While it has been known for some time that the combination of BRAF and a MEK inhibitor improves the clinical outcomes for patients with BRAF mutant metastatic melanoma compared with single-agent BRAF inhibition, this was the longest follow-up to date of any randomised trial investigating the treatment combination.
The trial was a randomised, open-label phase II BRF113220 study that sought to discover the effects of combining dabrafenib (an oral BRAF inhibitor) and trametinib (an oral MEK inhibitor), compared with dabrafenib monotherapy in patients with unresectable stage III or IV BRAF V600E/K mutation-positive metastatic melanoma.
Researchers found that the long-term survival of patients with BRAF V600-mutated melanoma is achievable, especially in those with favourable baseline characteristics. Overall, 28 percent of the patients treated with the combination of dabrafenib and trametinib remained alive for five years.
In a subgroup of patients with normal baseline LDH and fewer than three organ sites with metastases, approximately half of the patients remained alive for five years.
No new safety signals were identified with the long-term combination treatment.
Researchers concluded that targeted therapy with dabrafenib plus trametinib should be considered by physicians when making treatment decisions regarding patients with unresectable stage III or IV BRAF V600E/K-mutant metastatic melanoma.
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Long, G.V. et al. (May 2017) Five-year overall survival (OS) update from a phase II, open-label trial of dabrafenib (D) and trametinib (T) in patients (pts) with BRAF V600–mutant unresectable or metastatic melanoma (MM). Journal of Clinical Oncology. DOI: 10.1200/JCO.2017.35.15.
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