In a nutshell
This study investigated the overall survival and clinical characteristics of metastatic (spread to other parts of the body) melanoma patients undergoing therapy with dabrafenib (Tafinlar) combined with trametinib (Mekinist).
Researchers suggested that the combined treatment is associated with improved overall survival when compared to dabrafenib alone. Patients with a good prognosis before starting treatment may benefit more.
Some melanoma patients have a mutation (permanant change) in the BRAF gene. BRAF and MEK inhibitors block the BRAF and MEK proteins, reducing tumor growth. The combination of dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor) improves the survival of patients with BRAF mutated melanoma when compared to chemotherapy alone and even dabrafenib alone. Prior studies have shown a tumor reduction in 95% of patients treated with this combination, showing a long-term positive effect. However, there are other therapies with long-term positive effects. It is necessary to understand which patients benefit the most from each type of therapy.
Methods & findings
This objective of this study was to report on overall survival and to analyze the clinical features of those patients who benefit the most when treated with these drugs.
This study included information on 78 patients who took part in two sections of a previous study and were treated with 150 mg of dabrafenib plus 2 mg of trametinib. 54 patients had been randomly assigned to recieve treatment instead of placebo (substance with no effect on the body). 24 patients took part in a non-randomzied version of the trial (all patients received the treatment). None of the participants had been treated with a BRAF inhibitor before.
The 3 year progression free survival (time from treatment until disease progression) ranged from 18% to 21%. Average overall survival (time from treatment until death from any cause) ranged from 25 to 27.4 months. The average 3-year overall survival rate ranged from 38% to 47%.
Factors like normal LDH (lactate dehydrogenase, an enzyme that indicates cell damage in the body), a complete response to treatment and fewer metastasis were associated with long-term positive effects.
The bottom line
This study suggests that the combination of dabrafenib and trametinib is associated with an overall survival of more than 2 years. Patients who have better prognosis at diagnosis may respond better.
Published By :
Journal of clinical oncology
Jan 25, 2016