Validation of dabrafenib-trametinib prognostic groups in patients treated with vemurafenib and cobimetinib for advanced BRAF-mutated melanoma

Melanoma Res. 2020 Jun;30(3):268-271. doi: 10.1097/CMR.0000000000000634.

Abstract

Prognostic groups defined by lactate dehydrogenase concentration and number of organ sites containing metastases have been reported for patients treated with dabrafenib and trametinib for advanced melanoma. We aimed to validate these prognostic groups for patients treated with vemurafenib and cobimetinib in the coBRIM and BRIM-3 clinical studies. Eight hundred nine patients were included, 240 treated with vemurafenib plus cobimetinib and 569 with vemurafenib. For patients treated with vemurafenib and cobimetinib, both overall survival (P < 0.001, c-statistic = 0.72) and progression-free survival (P < 0.001, c-statistic = 0.65) differed markedly between prognostic groups. Two-year progression-free survival ranged from 3 (lactate dehydrogenase ≥2 times the upper limit of normal) to 50% (normal lactate dehydrogenase and ≤3 sites), and two-year overall survival ranged from 7 to 71%. For patients treated with vemurafenib monotherapy, overall survival (P < 0.001, c-statistic = 0.66) and progression-free survival (P < 0.001, c-statistic = 0.62) also differed significantly between prognostic groups. In conclusion, prognostic groups identified for patients treated with dabrafenib and trametinib are also applicable to patients treated with vemurafenib and cobimentinib.

Publication types

  • Clinical Trial, Phase III
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Azetidines / administration & dosage
  • Biomarkers / blood*
  • Female
  • Humans
  • Imidazoles / administration & dosage
  • L-Lactate Dehydrogenase / blood*
  • Male
  • Melanoma / blood*
  • Melanoma / drug therapy*
  • Melanoma / pathology*
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Mutation
  • Oximes / administration & dosage
  • Piperidines / administration & dosage
  • Prognosis
  • Progression-Free Survival
  • Proto-Oncogene Proteins B-raf / genetics
  • Pyridones / administration & dosage
  • Pyrimidinones / administration & dosage
  • Skin Neoplasms / blood*
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / pathology*
  • Treatment Outcome
  • Vemurafenib / administration & dosage

Substances

  • Azetidines
  • Biomarkers
  • Imidazoles
  • Oximes
  • Piperidines
  • Pyridones
  • Pyrimidinones
  • Vemurafenib
  • trametinib
  • L-Lactate Dehydrogenase
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • cobimetinib
  • dabrafenib