In a nutshell
The study aimed to investigate the frequency and severity of skin rash-like symptoms known as exanthema and its relationship with treatment outcome with vemurafenib (Zelboraf) alone or vemurafenib combined with cobimetinib (Cotellic) in patients with advanced melanoma. The study showed that the appearance of exanthema within 6 weeks of starting treatment was associated with good outcomes in these patients.
Some background
Melanoma is an aggressive form of skin cancer. In its advanced stage, it spreads to different parts of the body (metastatic). BRAF and MEK are the most common mutated (abnormal) genes in melanoma. The tumors with these mutations grow at a rapid pace and become metastatic. Vemurafenib and cobimetinib are targeted therapies that block these mutated genes and arrest the progress of melanoma. Treatment with these drugs is often associated with skin rash-like symptoms known as exanthema.
It is not yet known if the appearance of the exanthema in early weeks of treatment with vemurafenib alone or vemurafenib plus cobimetinib is associated with response to treatment in patients with advanced melanoma.
Methods & findings
The study included data from 422 patients with advanced melanoma. 299 patients received vemurafenib alone (group 1) and 123 patients received vemurafenib and cobimetinib (group 2). The development of exanthema was evaluated in relation to response to treatment and survival. The average follow-up duration was 21.6 month.
61 patients (20.4%) in group 1 and 53 (43.1%) in group 2 experienced early exanthema within 6 weeks after the start of therapy. In both groups, patients showing early exanthema had a better therapy response (59% in group 1 and 66% in group 2) compared to the patients without skin reaction (38.7% in group 1 and 54.3%).
In group 1, the development of early exanthema was not significantly associated with improved survival. However, in group 2, the appearance of early exanthema during treatment, was associated with significantly better average survival (longer than 21.6 months vs 11.6 months) and disease progression free survival (9.7 months vs 5.6 months) compared to those without this reaction.
The bottom line
This study showed that the occurrence of early exanthema within the first 6 weeks of therapy with vemurafenib or vemurafenib and cobimetinib was associated with better treatment response in patients with advanced melanoma.
The fine print
This study was based on medical records. Information might have been missing. This can affect the results. Further studies are needed.
Published By :
Frontiers in oncology
Date :
Jun 11, 2021
