First-line BRAF/MEK inhibitors versus anti-PD-1 monotherapy in BRAF V600 -mutant advanced melanoma patients: a propensity-matched survival analysis.

Autor: van Breeschoten J; Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, The Netherlands.; Department of Medical Oncology, Amsterdam UMC, VU University Medical Center, Cancer Center Amsterdam, De Boelelaan 1118, Amsterdam, 1081HZ, The Netherlands., Wouters MWJM; Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, Leiden, 2333AA, The Netherlands.; Department of Surgical Oncology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, The Netherlands., Hilarius DL; Department of Pharmacy, Rode Kruis Ziekenhuis, Vondellaan 13, Beverwijk, 1942LE, The Netherlands., Haanen JB; Department of Medical Oncology and Immunology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, The Netherlands., Blank CU; Department of Medical Oncology and Immunology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, The Netherlands.; Department of Molecular Oncology & Immunology, Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066CX, The Netherlands., Aarts MJB; Department of Medical Oncology, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, 6229 HX, The Netherlands., van den Berkmortel FWPJ; Department of Medical Oncology, Zuyderland Medical Centre Sittard, Dr. H. van der Hoffplein 1, Sittard-Geleen, 6162BG, The Netherlands., de Groot JB; Isala Oncology Center, Isala, Dokter van Heesweg 2, Zwolle, 8025AB, The Netherlands., Hospers GAP; Department of Medical Oncology, University Medical Centre Groningen, Hanzeplein 1, Groningen, 9713GZ, The Netherlands., Kapiteijn E; Department of Medical Oncology, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2333ZA, The Netherlands., Piersma D; Department of Internal Medicine, Medisch Spectrum Twente, Koningsplein 1, Enschede, 7512KZ, The Netherlands., van Rijn RS; Department of Internal Medicine, Medical Centre Leeuwarden, Henri Dunantweg 2, Leeuwarden, 8934AD, The Netherlands., Suijkerbuijk KPM; Department of Medical Oncology, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, 3584CX, The Netherlands., Blokx WAM; Department of Pathology, Division of Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht. Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands., Tije BJT; Department of Internal Medicine, Amphia Hospital, Molengracht 21, Breda, 4818CK, The Netherlands., Veldt AAMV; Departments of Medical Oncology and Radiology & Nuclear Medicine, Erasmus Medical Centre, 's-Gravendijkwal 230, Rotterdam, 3015CE, The Netherlands., Vreugdenhil A; Department of Internal Medicine, Maxima Medical Centre, De Run 4600, Eindhoven, 5504DB, The Netherlands., Boers-Sonderen MJ; Department of Medical Oncology, Radboud University Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, 6525GA, The Netherlands., van den Eertwegh AJM; Department of Medical Oncology, Amsterdam UMC, VU University Medical Center, Cancer Center Amsterdam, De Boelelaan 1118, Amsterdam, 1081HZ, The Netherlands. vandeneertwegh@amsterdamumc.nl.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2021 Mar; Vol. 124 (7), pp. 1222-1230. Date of Electronic Publication: 2021 Jan 26.
DOI: 10.1038/s41416-020-01229-1
Abstrakt: Background: Anti-PD-1 antibodies and BRAF/MEK inhibitors are the two main groups of systemic therapy in the treatment of BRAF V600 -mutant advanced melanoma. Until now, data are inconclusive on which therapy to use as first-line treatment. The aim of this study was to use propensity score matching to compare first-line anti-PD-1 monotherapy vs. BRAF/MEK inhibitors in advanced BRAF V600 -mutant melanoma patients.
Methods: We selected patients diagnosed between 2014 and 2017 with advanced melanoma and a known BRAF V600 -mutation treated with first-line BRAF/MEK inhibitors or anti-PD-1 antibodies, registered in the Dutch Melanoma Treatment Registry. Patients were matched based on their propensity scores using the nearest neighbour and the optimal matching method.
Results: Between 2014 and 2017, a total of 330 and 254 advanced melanoma patients received BRAF/MEK inhibitors and anti-PD-1 monotherapy as first-line systemic therapy. In the matched cohort, patients receiving anti-PD-1 antibodies as a first-line treatment had a higher median and 2-year overall survival compared to patients treated with first-line BRAF/MEK inhibitors, 42.3 months (95% CI: 37.3-NE) vs. 19.8 months (95% CI: 16.7-24.3) and 65.4% (95% CI: 58.1-73.6) vs. 41.7% (95% CI: 34.2-51.0).
Conclusions: Our data suggest that in the matched BRAF V600 -mutant advanced melanoma patients, anti-PD-1 monotherapy is the preferred first-line treatment in patients with relatively favourable patient and tumour characteristics.
Databáze: MEDLINE
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