Menzer, Christian, Menzies, Alexander M., Carlino, Matteo S., Reijers, Irene, Groen, Emma J., Eigentler, Thomas, de Groot, Jan Willem B., van der Veldt, Astrid A. M., Johnson, Douglas B., Meiss, Frank, Schlaak, Max, Schilling, Bastian, Westgeest, Hans M., Gutzmer, Ralf, Pfoehler, Claudia, Meier, Friedegund, Zimmer, Lisa, Suijkerbuijk, Karijn P. M., Haalck, Thomas, Thoms, Kai-Martin, Herbschleb, Karin, Leichsenring, Jonas, Menzer, Alexander, Kopp-Schneider, Annette, Long, Georgina V., Kefford, Richard ORCID: 0000-0001-9251-9229, Enk, Alexander, Blank, Christian U. and Hassel, Jessica C. (2019). Targeted Therapy in Advanced Melanoma With Rare BRAF Mutations. J. Clin. Oncol., 37 (33). S. 3142 - 3163. ALEXANDRIA: AMER SOC CLINICAL ONCOLOGY. ISSN 1527-7755

Full text not available from this repository.

Abstract

PURPOSE BRAF/MEK inhibition is a standard of care for patients with BRAF V600E/K-mutated metastatic melanoma. For patients with less frequent BRAF mutations, however, efficacy data are limited. METHODS In the current study, 103 patients with metastatic melanoma with rare, activating non-V600E/K BRAF mutations that were treated with either a BRAF inhibitor (BRAFi), MEK inhibitor (MEKi), or the combination were included. BRAF mutation, patient and disease characteristics, response, and survival data were analyzed. RESULTS Fifty-eight patient tumors (56%) harbored a non-E/K V600 mutation, 38 (37%) a non-V600 mutation, and seven had both V600E and a rare BRAF mutation (7%). The most frequent mutations were V600R (43%; 44 of 103), L597P/Q/R/S (15%; 15 of 103), and K601E (11%; 11 of 103). Most patients had stage IV disease and 42% had elevated lactate dehydrogenase at BRAFi/MEKi initiation. Most patients received combined BRAFi/ MEKi (58%) or BRAFi monotherapy (37%). Of the 58 patients with V600 mutations, overall response rate to BRAFi monotherapy and combination BRAFi/MEKi was 27% (six of 22) and 56% (20 of 36), respectively, whereas median progression-free survival (PFS) was 3.7 months and 8.0 months, respectively (P = .002). Of the 38 patients with non-V600 mutations, overall response rate was 0% (zero of 15) to BRAFi, 40% (two of five) to MEKi, and 28% (five of 18) to combination treatment, with a median PFS of 1.8 months versus 3.7 months versus 3.3 months, respectively. Multivariable analyses revealed superior survival (PFS and overall survival) with combination over monotherapy in rare V600 and non-V600 mutated melanoma. CONCLUSION Patients with rare BRAF mutations can respond to targeted therapy, however, efficacy seems to be lower compared with V600E mutated melanoma. Combination BRAFi/MEKi seems to be the best regimen for both V600 and non-V600 mutations. Yet interpretation should be done with care because of the heterogeneity of patients with small sample sizes for some of the reported mutations. (C) 2019 by American Society of Clinical Oncology

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Menzer, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Menzies, Alexander M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Carlino, Matteo S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reijers, IreneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Groen, Emma J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eigentler, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Groot, Jan Willem B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van der Veldt, Astrid A. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Johnson, Douglas B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meiss, FrankUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlaak, MaxUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schilling, BastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Westgeest, Hans M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gutzmer, RalfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfoehler, ClaudiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meier, FriedegundUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zimmer, LisaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Suijkerbuijk, Karijn P. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haalck, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thoms, Kai-MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herbschleb, KarinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Leichsenring, JonasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Menzer, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kopp-Schneider, AnnetteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Long, Georgina V.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kefford, RichardUNSPECIFIEDorcid.org/0000-0001-9251-9229UNSPECIFIED
Enk, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blank, Christian U.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hassel, Jessica C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-127354
DOI: 10.1200/JCO.19.00489
Journal or Publication Title: J. Clin. Oncol.
Volume: 37
Number: 33
Page Range: S. 3142 - 3163
Date: 2019
Publisher: AMER SOC CLINICAL ONCOLOGY
Place of Publication: ALEXANDRIA
ISSN: 1527-7755
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CUTANEOUS MELANOMA; CLINICOPATHOLOGICAL FEATURES; BRAF(L597) MUTATIONS; CLINICAL-OUTCOMES; DOUBLE-BLIND; DABRAFENIB; TRAMETINIB; VEMURAFENIB; INHIBITOR; SURVIVALMultiple languages
OncologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/12735

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item