Adjuvant BRAF-MEK Inhibitors versus Anti PD-1 Therapy in Stage III Melanoma

Autor:	Melissa M. De Meza, Willeke A. M. Blokx, Johannes J. Bonenkamp, Christian U. Blank, Maureen J. B. Aarts, Franchette W. P. J. van den Berkmortel, Marye J. Boers-Sonderen, Jan Willem B. De Groot, John B. A. G. Haanen, Geke A. P. Hospers, Ellen Kapiteijn, Olivier J. Van Not, Djura Piersma, Rozemarijn S. Van Rijn, Marion Stevense-den Boer, Astrid A. M. Van der Veldt, Gerard Vreugdenhil, Alfonsus J. M. Van den Eertwegh, Karijn P. M. Suijkerbuijk, Michel W. J. M. Wouters
Přispěvatelé:	Radiology & Nuclear Medicine, Internal medicine, Medical oncology, AII - Cancer immunology, CCA - Cancer Treatment and quality of life, CCA - Cancer biology and immunology, Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Interne Geneeskunde, MUMC+: MA Medische Oncologie (9)
Jazyk:	angličtina
Rok vydání:	2023
Předmět:	Cancer Research melanoma adjuvant therapy targeted therapy immune checkpoint inhibition MULTICENTER TRAMETINIB DABRAFENIB Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] POOLED ANALYSIS Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] All institutes and research themes of the Radboud University Medical Center Oncology SDG 3 - Good Health and Well-being SURVIVAL METASTATIC MELANOMA
Zdroj:	Cancers, 15(2):409. Multidisciplinary Digital Publishing Institute (MDPI) Cancers, 15(2). MDPI Cancers, 15, 2 de Meza, M M, Blokx, W A M, Bonenkamp, J J, Blank, C U, Aarts, M J B, van den Berkmortel, F W P J, Boers-Sonderen, M J, de Groot, J W B, Haanen, J B A G, Hospers, G A P, Kapiteijn, E, van Not, O J, Piersma, D, van Rijn, R S, Stevense-den Boer, M, van der Veldt, A A M, Vreugdenhil, G, van den Eertwegh, A J M, Suijkerbuijk, K P M & Wouters, M W J M 2023, ' Adjuvant BRAF-MEK Inhibitors versus Anti PD-1 Therapy in Stage III Melanoma : A Propensity-Matched Outcome Analysis ', Cancers, vol. 15, no. 2, 409 . https://doi.org/10.3390/cancers15020409 Cancers; Volume 15; Issue 2; Pages: 409 Cancers, 15
ISSN:	2072-6694
DOI:	10.3390/cancers15020409
Popis:	Simple Summary BRAF/MEK therapy and anti-PD-1 therapy have shown better recurrence-free survival of stage III melanoma in patients with BRAF V600 mutations in clinical trials. However, little is known about how these therapies compare to each other in everyday practice. The aim of our study was to describe the toxicity and survival of patients treated with BRAF/MEK therapy and anti-PD-1 therapy in daily practice. We demonstrated that grade >= 3 toxicity occurred in 11.5% of patients and was the most common cause of early treatment discontinuation (71.1%). We also show that at 12 months, patients treated with BRAF/MEK therapy have less progression than those treated with anti-PD-1 therapy. However, this is no longer the case at 18 months. Adjuvant BRAF/MEK- and anti-PD-1 inhibition have significantly improved recurrence-free survival (RFS) compared to placebo in resected stage III BRAF-mutant melanoma. However, data beyond the clinical trial setting are limited. This study describes the toxicity and survival of patients treated with adjuvant BRAF/MEK inhibitors and compares outcomes to adjuvant anti-PD-1. For this study, stage III BRAF V600 mutant cutaneous melanoma patients treated with adjuvant BRAF/MEK-inhibition or anti-PD-1 were identified from the Dutch Melanoma Treatment Registry. BRAF/MEK- and anti-PD-1-treated patients were matched based on propensity scores, and RFS at 12 and 18 months were estimated. Between 1 July 2018 and 31 December 2021, 717 patients were identified. Of these, 114 patients with complete records were treated with BRAF/MEK therapy and 532 with anti-PD-1. Comorbidities (p = 0.04) and geographical region (p < 0.01) were associated with treatment choice. In 45.6% of BRAF/MEK-treated patients, treatment was prematurely discontinued. Grade >= 3 toxicity occurred in 11.5% of patients and was the most common cause of early discontinuation (71.1%). At 12 and 18 months, RFS in BRAF/MEK-treated patients was 85% and 70%, compared to 68% and 68% in matched anti-PD-1-treated patients (p = 0.03). In conclusion, comorbidities and geographical region determine the choice of adjuvant treatment in patients with resected stage III BRAF-mutant melanoma. With the currently limited follow-up, BRAF/MEK-treated patients have better RFS at 12 months than matched anti-PD-1-treated patients, but this difference is no longer observed at 18 months. Therefore, longer follow-up data are necessary to estimate long-term effectiveness.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3601b23aa21c729b0a455facbd7e5ade https://doi.org/10.3390/cancers15020409 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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