open access

Vol 16, No 4 (2020)
Research paper
Published online: 2020-06-01
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Immunotherapy or targeted therapy as first-line treatment of patients with advanced/metastatic melanoma with the BRAF mutation — a single-center analysis

Bożena Cybulska-Stopa, Karolina Piejko, Renata Pacholczak, Małgorzata Domagała-Haduch, Anna Drosik-Kwaśniewska, Agata Sałek-Zań, Patrycja Wiktor-Mucha, Janusz Rolski, Tomasz Zemełka
DOI: 10.5603/OCP.2020.0023
·
Oncol Clin Pract 2020;16(4):194-200.

open access

Vol 16, No 4 (2020)
ORIGINAL ARTICLE
Published online: 2020-06-01

Abstract

Introduction. One of the most important achievements of contemporary oncology is the discovery of new therapeutic possibilities: targeted therapy and immunotherapy associated with checkpoint inhibitors. It has not been unequivocally determined so far which therapy should be used as first-line treatment in patients with advanced/metastatic melanoma with the BRAF mutation.

Material and methods. 137 patients with advanced/metastatic melanoma with the BRAF mutation were analyzed. They received anti-PD1-1 therapy (IT) or molecularly targeted therapy iBRAF ± iMEK (TT) as first-line treatment in the scope of the national drug program. IT and TT therapies used as first-line treatment were compared.

Results. Median OS and PFS in the group were 14.0 and 7.3 months. Unfavorable prognostic factors for OS and PFS were metastases to the central nervous system, increased LDH levels and performance status > 1. Metastatic sites in > 2 locations were only unfavorable prognostic factors for OS. A statistically significant difference was found between TT and IT for OS (p = 0.0011; median for TT was 12.6 months and was not reached for IT). It should be noted that the group treated with TT was characterized by a worse prognostic factors. No differences in PFS were observed (p = 0.292, medians 7.2 and 9.0 months, respectively).

Conclusion. In patients with advanced/metastatic melanoma with a BRAF mutation without rapid progression, IT should be considered as first-line therapy.

Abstract

Introduction. One of the most important achievements of contemporary oncology is the discovery of new therapeutic possibilities: targeted therapy and immunotherapy associated with checkpoint inhibitors. It has not been unequivocally determined so far which therapy should be used as first-line treatment in patients with advanced/metastatic melanoma with the BRAF mutation.

Material and methods. 137 patients with advanced/metastatic melanoma with the BRAF mutation were analyzed. They received anti-PD1-1 therapy (IT) or molecularly targeted therapy iBRAF ± iMEK (TT) as first-line treatment in the scope of the national drug program. IT and TT therapies used as first-line treatment were compared.

Results. Median OS and PFS in the group were 14.0 and 7.3 months. Unfavorable prognostic factors for OS and PFS were metastases to the central nervous system, increased LDH levels and performance status > 1. Metastatic sites in > 2 locations were only unfavorable prognostic factors for OS. A statistically significant difference was found between TT and IT for OS (p = 0.0011; median for TT was 12.6 months and was not reached for IT). It should be noted that the group treated with TT was characterized by a worse prognostic factors. No differences in PFS were observed (p = 0.292, medians 7.2 and 9.0 months, respectively).

Conclusion. In patients with advanced/metastatic melanoma with a BRAF mutation without rapid progression, IT should be considered as first-line therapy.

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Keywords

melanoma, immunotherapy, targeted therapy, sequential therapy, BRAF mutation

About this article
Title

Immunotherapy or targeted therapy as first-line treatment of patients with advanced/metastatic melanoma with the BRAF mutation — a single-center analysis

Journal

Oncology in Clinical Practice

Issue

Vol 16, No 4 (2020)

Article type

Research paper

Pages

194-200

Published online

2020-06-01

DOI

10.5603/OCP.2020.0023

Bibliographic record

Oncol Clin Pract 2020;16(4):194-200.

Keywords

melanoma
immunotherapy
targeted therapy
sequential therapy
BRAF mutation

Authors

Bożena Cybulska-Stopa
Karolina Piejko
Renata Pacholczak
Małgorzata Domagała-Haduch
Anna Drosik-Kwaśniewska
Agata Sałek-Zań
Patrycja Wiktor-Mucha
Janusz Rolski
Tomasz Zemełka

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