• Douglas B Johnson, Keith T Flaherty, Jeffrey S Weber, Jeffrey R Infante, Kevin B Kim, Richard F Kefford, Omid Hamid, Lynn Schuchter, Jonathan Cebon, William H Sharfman, Robert R McWilliams, Mario Sznol, Donald P Lawrence, Geoffrey T Gibney, Howard A Burris, Gerald S Falchook, Alain Algazi, Karl Lewis, Georgina V Long, Kiran Patel, Nageatte Ibrahim, Peng Sun, Shonda Little, Elizabeth Cunningham, Jeffrey A Sosman, Adil Daud, and Rene Gonzalez.
• 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.
• J. Clin. Oncol. 2014 Nov 20;32(33):3697-704.

PurposePreclinical 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.Patients And MethodsIn 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).ResultsIn 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%).ConclusionDabrafenib 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.© 2014 by American Society of Clinical Oncology.

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