Dabrafenib combined with trametinib before surgery for patients with stage 3 melanoma

This study evaluated the safety and effectiveness of dabrafenib (Tafinlar) and trametinib (Mekinist) together before surgery to remove stage three melanoma. The study found that a high proportion of patients treated in this way had no signs of cancer left.

Dabrafenib and trametinib are anti-cancer medications. They work in cases of melanoma cancer that has a mutation (abnormal gene) in it, called the BRAF mutation. It has been shown that treating patients with melanoma by surgically removing the cancer, then giving dabrafenib and trametinib is effective. It is not known if giving dabrafenib and trametinib first, followed by surgery, will be effective. 

This study had 35 patients. All of these patients had stage 3 melanoma. All patients were suitable for surgery. All of the patients had the BRAF mutation in the cancer cells. All of the patients took dabrafenib and trametinib for three months. Then they had surgery to remove the tumor. They then continued to take dabrafenib and trametinib for another nine months. The patients were followed for 27 months. 

After 3 months of treatment just with dabrafenib and trametinib, the cancer had not grown in any of the patients. 46% of the patients had no trace of the tumor remaining. 40% of the patients had partly responded to the treatment. 14% of patients had tumors that remained the same.

After surgery and nine months of further treatment, all of the patients had responded to treatment. 49% of patients had no trace of cancer in the body. 51% of patients had almost no trace of cancer remaining in the body. Serious side effects were noted in 17% of patients. These side effects were fever, heart problems, and kidney problems. 

The study concluded that using dabrafenib and trametinib before surgery to remove stage 3 melanoma is safe and effective. 

This is a small study. Larger studies should be done to confirm the results. This study was funded by GlaxoSmithKline and Novartis, the manufacturers of dabrafenib and trametinib.