Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/12419
Title: Combined BRAF (Dabrafenib) and MEK inhibition (Trametinib) in patients with BRAFV600-mutant melanoma experiencing progression with single-agent BRAF inhibitor.
Authors: Johnson, Douglas B;Flaherty, Keith T;Weber, Jeffrey S;Infante, Jeffrey R;Kim, Kevin B;Kefford, Richard F;Hamid, Omid;Schuchter, Lynn;Cebon, Jonathan S;Sharfman, William H;McWilliams, Robert R;Sznol, Mario;Lawrence, Donald P;Gibney, Geoffrey T;Burris, Howard A;Falchook, Gerald S;Algazi, Alain;Lewis, Karl;Long, Georgina V;Patel, Kiran;Ibrahim, Nageatte;Sun, Peng;Little, Shonda;Cunningham, Elizabeth;Sosman, Jeffrey A;Daud, Adil;Gonzalez, Rene
Affiliation: Douglas B. Johnson and Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center; Jeffrey R. Infante and Howard A. Burris III, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Keith T. Flaherty and Donald P. Lawrence, Massachusetts General Hospital Cancer Center, Boston MA; Jeffrey S. Weber and Geoffrey T. Gibney, Moffitt Cancer Center, Tampa, FL; Kevin B. Kim and Gerald S. Falchook, University of Texas MD Anderson Cancer Center, Houston, TX; Richard F. Kefford and Georgina V. Long, Melanoma Institute Australia, University of Sydney and Westmead Hospital, Sydney, New South Wales; Jonathan Cebon, Joint Ludwig-Austin Oncology Unit, Austin Health, Melbourne, Victoria, Australia; Omid Hamid, Angeles Clinic and Research Institute, Los Angeles; Alain Algazi and Adil Daud, University of California, San Francisco, San Francisco, CA; Lynn Schuchter, University of Pennsylvania Abramson Cancer Center; Nageatte Ibrahim, Peng Sun, Shonda Little, and Elizabeth Cunningham, GlaxoSmithKline, Philadelphia, PA; William H. Sharfman, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Robert R. McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; Karl Lewis and Rene Gonzalez, University of Colorado, Denver, CO; and Kiran Patel, Incyte, Wilmington, DE. douglas.b.johnson@vanderbilt.edu.
Douglas B. Johnson and Jeffrey A. Sosman, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center; Jeffrey R. Infante and Howard A. Burris III, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN; Keith T. Flaherty and Donald P. Lawrence, Massachusetts General Hospital Cancer Center, Boston MA; Jeffrey S. Weber and Geoffrey T. Gibney, Moffitt Cancer Center, Tampa, FL; Kevin B. Kim and Gerald S. Falchook, University of Texas MD Anderson Cancer Center, Houston, TX; Richard F. Kefford and Georgina V. Long, Melanoma Institute Australia, University of Sydney and Westmead Hospital, Sydney, New South Wales; Jonathan Cebon, Joint Ludwig-Austin Oncology Unit, Austin Health, Melbourne, Victoria, Australia; Omid Hamid, Angeles Clinic and Research Institute, Los Angeles; Alain Algazi and Adil Daud, University of California, San Francisco, San Francisco, CA; Lynn Schuchter, University of Pennsylvania Abramson Cancer Center; Nageatte Ibrahim, Peng Sun, Shonda Little, and Elizabeth Cunningham, GlaxoSmithKline, Philadelphia, PA; William H. Sharfman, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD; Robert R. McWilliams, Mayo Clinic, Rochester, MN; Mario Sznol, Yale University School of Medicine and Smilow Cancer Center, Yale-New Haven Hospital, New Haven, CT; Karl Lewis and Rene Gonzalez, University of Colorado, Denver, CO; and Kiran Patel, Incyte, Wilmington, DE.
Issue Date: 6-Oct-2014
Citation: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology 2014; 32(33): 3697-704
Abstract: Preclinical and early clinical studies have demonstrated that initial therapy with combined BRAF and MEK inhibition is more effective in BRAF(V600)-mutant melanoma than single-agent BRAF inhibitors. This study assessed the safety and efficacy of dabrafenib and trametinib in patients who had received prior BRAF inhibitor treatment.In this open-label phase I/II study, we evaluated the pharmacology, safety, and efficacy of dabrafenib and trametinib. Here, we report patients treated with combination therapy after disease progression with BRAF inhibitor treatment administered before study enrollment (part B; n = 26) or after cross-over at progression with dabrafenib monotherapy (part C; n = 45).In parts B and C, confirmed objective response rates (ORR) were 15% (95% CI, 4% to 35%) and 13% (95% CI, 5% to 27%), respectively; an additional 50% and 44% experienced stable disease ≥ 8 weeks, respectively. In part C, median progression-free survival (PFS) was 3.6 months (95% CI, 2 to 4), and median overall survival was 11.8 months (95% CI, 8 to 25) from cross-over. Patients who previously received dabrafenib ≥ 6 months had superior outcomes with the combination compared with those treated < 6 months; median PFS was 3.9 (95% CI, 3 to 7) versus 1.8 months (95% CI, 2 to 4; hazard ratio, 0.49; P = .02), and ORR was 26% (95% CI, 10% to 48%) versus 0% (95% CI, 0% to 15%).Dabrafenib plus trametinib has modest clinical efficacy in patients with BRAF inhibitor-resistant melanoma. This regimen may be a therapeutic strategy for patients who previously benefited from BRAF inhibitor monotherapy ≥ 6 months but demonstrates minimal efficacy after rapid progression with BRAF inhibitor therapy.
Internal ID Number: 25287827
URI: http://ahro.austin.org.au/austinjspui/handle/1/12419
DOI: 10.1200/JCO.2014.57.3535
URL: http://www.ncbi.nlm.nih.gov/pubmed/25287827
Type: Journal Article
Subjects: Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols.therapeutic use
Disease Progression
Disease-Free Survival
Female
Humans
Imidazoles.administration & dosage.adverse effects
Male
Melanoma.drug therapy.genetics.mortality
Middle Aged
Mitogen-Activated Protein Kinase Kinases.antagonists & inhibitors
Mutation
Oximes.administration & dosage.adverse effects
Protein Kinase Inhibitors.administration & dosage.therapeutic use
Proto-Oncogene Proteins B-raf.antagonists & inhibitors.genetics
Pyridones.administration & dosage.adverse effects
Pyrimidinones.administration & dosage.adverse effects
Appears in Collections:Journal articles

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