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Soo Park, MD
Soo Park, MD
Posted: Monday, September 23, 2024
Switching to immune checkpoint inhibitors after targeted therapy may not provide better clinical outcomes than continuous targeted therapy for BRAF V600–positive advanced melanoma. Although there was no significant difference in overall survival in these patients, there was an increase in progression-free survival with continuous targeted therapy (arm A) compared with switching to immune checkpoint inhibition (arm B). The results of this phase II study were presented by Dirk Schadendorf, MD, of the University Hospital Essen, Germany, at the European Society for Medical Oncology (ESMO) Congress 2024 (Abstract LBA45).
“The better early tumor control (progression-free survival) in arm A and treatment options outside the trial diluted the overall effect size for early switch to immune checkpoint inhibitors,” stated the investigators. “No subgroups were identified for which a targeted therapies run-in (arm B) provided clinical benefit.”
Patients with BRAF V600–positive advanced melanoma were randomly assigned to receive continuous targeted treatment (arm A, n = 69) or were switched to the immune checkpoint inhibitor atezolizumab (arm B, n = 66). Patients in arm A received a 3-month run-in phase with vemurafenib (960 mg) and cobimetinib (60 mg) or continuous vemurafenib plus cobimetinib until disease progression and second-line atezolizumab (1,200 mg). Patients in arm B were switched to atezolizumab after the run-in phase and received vemurafenib plus cobimetinib upon disease progression.
At the median follow-up of 57 months, progression-free survival with continuous targeted therapy was better than with a switch to atezolizumab early in treatment (P = .006). Although it appeared that an early switch to the immune checkpoint inhibitor improved overall survival at 4 and 5 years (53% and 45%, respectively), these results were not statistically significant compared with those of patients who received continuous targeted therapy (42% and 40%, respectively). Absolute best objective response rates also did not differ across groups.
Disclosure: For full disclosures of the study authors, visit cslide.ctimeetingtech.com.
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