1. Long-term survival of patients with advanced melanoma treated with BRAF-MEK inhibitors
- Author
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Ismail, Rawa K, Suijkerbuijk, Karijn P M, de Boer, Anthonius, van Dartel, Maaike, Hilarius, Doranne L, Pasmooij, Anna M J, van Zeijl, Michiel C T, Aarts, Maureen J B, van den Berkmortel, Franchette W P J, Blank, Christian U, Boers-Sonderen, Marye J, de Groot, Jan W B, Haanen, John B, Hospers, Geke A P, Kapiteijn, Ellen, Piersma, Djura, van Rijn, Rozemarijn S, van der Veldt, Astrid A M, Vreugdenhil, Art, Westgeest, Hans, van den Eertwegh, Alfons J, Wouters, Michel W J M, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Medical Oncology, Radiology & Nuclear Medicine, Internal medicine, Medical oncology, CCA - Cancer Treatment and quality of life, Obstetrics and gynaecology, Guided Treatment in Optimal Selected Cancer Patients (GUTS), Interne Geneeskunde, MUMC+: MA Medische Oncologie (9), and RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy
- Subjects
Mitogen-Activated Protein Kinase Kinases ,Proto-Oncogene Proteins B-raf ,advanced melanoma ,Cancer Research ,Skin Neoplasms ,Brain Neoplasms ,Dermatology ,BRAF-MEK inhibitors ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,survival rates ,All institutes and research themes of the Radboud University Medical Center ,SDG 3 - Good Health and Well-being ,adrenal ,Oncology ,Antineoplastic Combined Chemotherapy Protocols ,Mutation ,melanoma ,Humans ,Protein Kinase Inhibitors ,radiotherapy - Abstract
BACKGROUND: Recent results of patients with advanced melanoma treated with first-line BRAF-MEK inhibitors in clinical trials showed 5-year survival in one-third of patients with a median overall survival (OS) of more than 2 years. This study aimed to investigate these patients' real-world survival and identify the characteristics of long-term survivors.PATIENTS AND METHODS: The study population consisted of patients with advanced cutaneous melanoma with a BRAF-V600 mutated tumor who were treated with first-line BRAF-MEK inhibitors between 2013 and 2017. Long-term survival was defined as a minimum OS of 2 years from start therapy.RESULTS: The median progression-free survival (mPFS) and median OS (mOS) of real-world patients (n = 435) were respectively 8.0 (95% CI, 6.8-9.4) and 11.7 (95% CI, 10.3-13.5) months. Two-year survival was reached by 28% of the patients, 22% reached 3-year survival and 19% reached 4-year survival. Real-world patients often had brain metastases (41%), stage IV M1c disease (87%), ECOG PS ≥2 (21%), ≥3 organ sites (62%) and elevated LDH of ≥250 U/I (49%). Trial-eligible real-world patients had an mOS of 17.3 months. Patients surviving more than 2 years (n = 116) more often had an ECOG PS ≤1 (83%), normal LDH (60%), no brain metastases (60%), no liver metastases (63%) and CONCLUSION: Long-term survival of real-world patients treated with first-line BRAF-MEK inhibitors is significantly lower than that of trial patients, which is probably explained by poorer baseline characteristics of patients treated in daily practice. Long-term survivors generally had more favorable characteristics with regard to age, LDH level and metastatic sites, compared to patients not reaching long-term survival.
- Published
- 2022