Long-term survival of patients with advanced melanoma treated with BRAF-MEK inhibitors. Issue 6 (5th September 2022)

• Record Type: Journal Article
• Authors: Ismail, Rawa K.; Suijkerbuijk, Karijn P.M.; de Boer, Anthonius; van Dartel, Maaike; Hilarius, Doranne L.; Pasmooij, A.M.G.; 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.A.G.; 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.
• Is Part Of: Melanoma research. Volume 32:Issue 6(2022)
• Page Start: 460
• Page End: 468
• Publication Date: 2022-09-05
• Subjects: advanced melanoma -- BRAF-MEK inhibitors -- survival rates; Melanoma -- Periodicals; Melanoma -- Periodicals; Melanomen; 616.99477
• DOI: 10.1097/CMR.0000000000000832
• Languages: English
• ISSNs: 0960-8931

Abstract

Abstract : 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. 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. 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 17.9 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 <3 organ sites (60%). 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.