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Clinical and Translational Oncology

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01-01-2017 | Research Article

Sequential treatment with immunotherapy and BRAF inhibitors in BRAF-mutant advanced melanoma

Authors: F. Aya, A. Fernandez-Martinez, L. Gaba, I. Victoria, M. Tosca, E. Pineda, P. Gascon, A. Prat, A. Arance

Published in: Clinical and Translational Oncology | Issue 1/2017

Abstract

Purpose

Immunotherapy (IT) agents and BRAF inhibitors (BRAFi) are effective treatments for patients with advanced BRAF-mutant melanoma although the optimal sequence remains to be elucidated. The aim of this study was to compare the outcomes of two different cohorts of patients treated with BRAFi first, then IT or the reverse sequence.

Patients and methods

This is a retrospective study on two groups of patients: a cohort was treated first with BRAFi followed by immunotherapy (BRAFi-IT) and the other cohort with the reverse sequence (IT-BRAFi). Baseline characteristics and clinical outcomes were compared between the two cohorts.

Results

A total of 25 patients were included in the study. Sixteen patients were given BRAFi-IT sequence and nine received IT-BRAFi sequence. No differences were observed in the characteristics of patients prior to each treatment between cohorts. Objective response rate (ORR) achieved by BRAFi were not different among groups. ORR achieved by IT was higher when administered after BRAFi (43.8 vs 0 %). Survival rates at 1–2 years were similar in both cohorts and median overall survival was not different for BRAFi-IT and IT-BRAFi (log rank test p = 0.97).

Conclusions

No differences were observed in OS between the two cohorts. These results support the indistinct use of IT or BRAFi as initial treatment in patients with metastatic BRAF-mutant melanoma, although higher rate of response to IT was observed when administered after BRAFi. Prospective randomized clinical trials are needed on this issue.

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Title: Sequential treatment with immunotherapy and BRAF inhibitors in BRAF-mutant advanced melanoma
Authors: F. Aya
A. Fernandez-Martinez
L. Gaba
I. Victoria
M. Tosca
E. Pineda
P. Gascon
A. Prat
A. Arance
Publication date: 01-01-2017
Publisher: Springer International Publishing
Published in: Clinical and Translational Oncology / Issue 1/2017
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI: https://doi.org/10.1007/s12094-016-1514-0

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Abstract

Purpose

Patients and methods

Results

Conclusions

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