In a nutshell
The authors evaluated the effect of dabrafenib (Tafinlar) in disease progression in melanoma patients with cancer that has spread to the brain (metastasis).
Some background
In advanced melanoma (stage III/IV) cancer spreads from the skin to other parts of the body, most commonly, to the brain. In the majority of metastatic melanoma patients, BRAF genes are mutated (permanently changed). These genes are involved in cellular signaling and protein function. In melanoma with BRAF mutations, these proteins remain permanently active. This results in uncontrolled growth of cancer cells.
Dabrafenib is an approved drug for BRAF-mutated melanoma. In phase I and II clinical trials, dabrafenib has also shown effectiveness in melanoma patients with brain metastasis. However, the extent of intracranial (IC – inside the brain) and extracranial (EC – outside the brain) responses to dabrafenib have not yet been reported. The response to treatment can be assessed by determining when tumors improve, stay the same or worsen, during treatment.
Further studies are needed in this aspect to better understand the effectiveness of dabrafenib in the control of melanoma progression.
Methods & findings
The authors aimed to analyze the extent of disease progression, IC response and EC response to dabrafenib in melanoma patients with brain metastasis.
23 melanoma patients with brain metastasis were included in this study. All patients had cancer that had spread to the brain. 52% of patients had no prior treatment for brain metastasis. 48% of patients had prior treatment for brain metastasis but experienced subsequent IC disease progression. In this study, all patients were treated with dabrafenib.
87% of patients responded to treatment. The median (midpoint) overall survival (patients who were still alive following treatment) was 36.6 weeks. The median overall progression-free survival (time following treatment before the disease progressed) in all patients was 16.3 weeks. The response rates at IC sites (locations) were 78% and were 90% at EC sites. The extent of response to treatment was similar in 71% of patients. The median progression-free survival was 23.6 weeks at both IC and EC sites.
Overall, 20 patients experienced disease progression. 6 patients had IC progression only. 6 patients had EC progression only. 8 patients had both IC and EC progression.
The bottom line
The authors concluded that melanoma patients with both IC and EC brain metastasis had similar responses to dabrafenib treatment.
The fine print
Larger patient groups are needed for results to be widely applied.
Published By :
Cancer
Date :
Feb 15, 2014
