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Survival Outcomes in BRAF-Mutant Melanoma: BRAF/MEK vs PD-1 Inhibitors

By: Vanessa A. Carter, BS
Posted: Friday, August 30, 2024

Manja Bloem, MD, of Leiden University Medical Center, Netherlands, and colleagues performed a study to compare the survival outcomes of anti–PD-1 immunotherapy with BRAF/MEK inhibitors in patients with high-risk melanoma. Their updated survival results with extended follow-up were presented during the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 9573).

“In our earlier study, we compared adjuvant BRAF/MEK inhibitors and anti–PD-1 in a nationwide cohort in the Netherlands. However, the follow-up was too limited for overall survival analysis,” stated the investigators. “Our [updated] results suggest no significant differences in outcomes between adjuvant BRAF/MEK inhibitors and anti–PD-1 treatment in stage III melanoma.”

A total of 954 patients with resected, high-risk, BRAF-mutated, stage III melanoma from the Dutch Melanoma Treatment Registry were enrolled in the study. BRAF/MEK inhibitor therapy was used in 225 patients, and 729 received anti–PD-1 therapy. Study endpoints included an outcome analysis of distant metastasis–free survival, recurrence-free survival, overall survival, grade 3 or higher toxicity rates, and treatment discontinuation rates.

The median duration of follow-up was 20.9 months. More comorbidities were observed with the use of BRAF/MEK inhibitors than with the use of anti–PD-1 therapy (76.0% vs 63.8%; P < .01); these patients also had lower rates of stage IIIA disease (16.4% vs 10.2%; P = .01).

Propensity score matching was used to create two similar groups of 213 patients. Recurrence-free survival and distant metastasis–free survival appeared to be significantly shorter among patients on anti–PD-1 therapy compared with those receiving BRAF/MEK inhibitors; overall survival was numerically higher among patients on anti–PD-1 treatment. With propensity score matching, however, survival rates did not statistically differ between treatment arms.

Disclosure: Dr. Bloem reported no conflicts of interest. For full disclosures of the other study authors, visit coi.asco.org.


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