Melanoma: skin reactions herald dabrafenib-trametinib efficacy

  • Consoli F & al.
  • PLoS ONE
  • 1 Jan 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Panniculitis and vitiligo-like lesions predict a better disease response and longer time to progression in patients with advanced melanoma receiving dabrafenib-trametinib combination therapy.

Why this matters

  • Immune-related skin lesions (IRSLs) may represent a useful surrogate marker for treatment response.
  • Combination treatment with BRAF/MEK inhibitors is standard of care in metastatic or locally advanced BRAF V600 mutated malignant melanoma.

Key results

  • 23% of patients developed IRSLs (15% panniculitis, 8% vitiligo).
  • IRSL diagnosis was associated with higher disease response rates (83% vs 25%; P=.001).
    • IRSLs were associated with response in multivariate analysis (HR, 0.16; P=.034).
  • IRSL diagnosis was associated with longer median PFS (not reached vs 9 months; P=.001) and OS (not reached vs 13 months; P=.002).
    • IRSLs were associated with longer PFS in multivariate analysis (HR, 0.19; P=.043).
    • Multivariate analysis for OS was not performed.

Study design

  • 52 patients with BRAF V600-mutated melanoma treated with combined dabrafenib and trametinib were analyzed for outcomes.
  • Funding: Patients and families; Fondazione Internazionale di Ricerca in Medicina.

Limitations

  • Retrospective study.
  • Small patient sample size.

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