Efficacy of combined BRAF-MEK inhibitor second-line therapy in patients with non-resectable or metastatic BRAFV600-positive melanoma after prior immunotherapy: A retrospective EUMelaReg multicenter study

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Eva Ellebaek - , Universität Kopenhagen (Autor:in)
  • Michael Weichenthal - , Universitätsklinikum Schleswig-Holstein Campus Kiel (Autor:in)
  • Iva Gavrilova - , Medical University Sofia (Autor:in)
  • Nethanel Asher - , Rabin Medical Center Israel (Autor:in)
  • Patrick Terheyden - , Universität zu Lübeck (Autor:in)
  • Jochen Utikal - , Universität Heidelberg (Autor:in)
  • Amina Jalovčić Suljeviić - , Univerzitet u Sarajevu (Autor:in)
  • Claudia Pföhler - , Universität des Saarlandes (Autor:in)
  • Igor Stojkovski - , University Clinic of Radiotherapy and Oncology (Autor:in)
  • Rudolf Alexander Herbst - , Fresenius AG (Autor:in)
  • Selma Ugurel - , Universität Bielefeld (Autor:in)
  • Christina Ruhlmann - , Universitätsklinikum Odense (Autor:in)
  • Alfonso Berrocal - , Hospital General Universitario de Valencia (Autor:in)
  • Margarita Majem - , Hospital de la Santa creu i Sant Pau (Autor:in)
  • Branko Dujovic - , Military Medical Academy (Autor:in)
  • Viktor Šabarić - , University of Zagreb (Autor:in)
  • Tomislav Duvancic - , Sestre Milosrdnice University Hospital Center (Autor:in)
  • Ainara Soria - , Hospital Ramon y Cajal (Autor:in)
  • Marco Donia - , Universität Kopenhagen (Autor:in)
  • Henrik Schmidt - , Universität Aarhus (Autor:in)
  • Rasmus B. Friis - , Universität Aarhus (Autor:in)
  • Alexander Gerasimov - , Medical University Sofia (Autor:in)
  • Gergana Shalamanova-Deleva - , Complex Oncology Center Plovdiv (Autor:in)
  • Ahmed Kontilev - , Tokuda Medical Centre (Autor:in)
  • Shaked Lev-Ari - , Sheba Medical Center at Tel Hashomer (Autor:in)
  • Ronnie Shapira - , Sheba Medical Center at Tel Hashomer (Autor:in)
  • Luisa Piccin - , IRCCS Istituto Oncologico Veneto - Padova (Autor:in)
  • Alessandro Minisini - , Azienda Sanitaria Universitaria del Friuli Centrale (Autor:in)
  • Berna C. Özdemir - , Universität Bern (Autor:in)
  • Pawel Teterycz - , Maria Sklodowska-Curie Institute of Oncology (Autor:in)
  • Anna Mariuk-Jarema - , Maria Sklodowska-Curie Institute of Oncology (Autor:in)
  • Dimitrios Ziogas - , National and Kapodistrian University of Athens (Autor:in)
  • Amalia Anastasopoulou - , National and Kapodistrian University of Athens (Autor:in)
  • Dimitra Stefanou - , National and Kapodistrian University of Athens (Autor:in)
  • Lourdes Gutiérrez - , Hospital Universitario Puerta de Hierro de Majadahonda (Autor:in)
  • Christoffer Gebhardt - , Universität Hamburg (Autor:in)
  • Reinhard Dummer - , Universität Zürich (Autor:in)
  • Axel Hauschild - , Universitätsklinikum Schleswig-Holstein Campus Kiel (Autor:in)
  • Peter Mohr - , Klinik und Poliklinik für Dermatologie (Autor:in)
  • Imke von Wasielewski - , Medizinische Hochschule Hannover (MHH) (Autor:in)
  • Friedegund Meier - , Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • John Haanen - , Netherlands Cancer Institute (Autor:in)
  • Inge Marie Svane - , Universität Kopenhagen (Autor:in)
  • Paolo A. Ascierto - , IRCCS Istituto nazionale tumori Fondazione Giovanni Pascale - Napoli (Autor:in)
  • Joanna Mangana - , Universität Zürich (Autor:in)
  • Piotr Rutkowski - , Maria Sklodowska-Curie Institute of Oncology (Autor:in)
  • Helen Gogas - , National and Kapodistrian University of Athens (Autor:in)
  • Lars Bastholt - , Universitätsklinikum Odense (Autor:in)
  • Dirk Schadendorf - , Universitätsklinikum Essen (Autor:in)

Abstract

Background: Randomised trials recently showed that sequencing of first-line (1 L) immune checkpoint inhibitor (ICI) and second-line (2 L) BRAF-MEK-inhibitor (BRAF/MEKi) combination therapy provides better clinical outcomes in BRAFV600-mutated, irresectable/metastatic melanoma than the inverse sequence. However, efficacy benchmark data for 2 L BRAF/MEKi are limited as the combination was developed for 1 L use, lacking estimates for the impact of prior ICI. Methods: This retrospectively study analysed 2343 patients from the EUMelaReg registry with BRAFV600-mutated melanoma who received BRAF/MEKi either as 2 L after failing 1 L ICI (n = 654) or as 1 L treatment (n = 1689). Patients with prior adjuvant ICI or BRAF/MEKi were excluded. Prognostic imbalances between the two groups were adjusted using 1:1 inverse propensity score matching. Key efficacy outcomes included overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and time on treatment (TOT). Results: Patients in the 2 L cohort achieved outcomes from start of treatment at least equivalent to the matched 1 L BRAF/MEKi cohort. Kaplan-Meier estimates demonstrated longer median PFS (8.4 vs 7.7 months; p = 0.01) and longer median TOT (7.8 vs 6.2 months; p = 0.002) for patients treated with 2 L BRAF/MEKi compared to 1 L. Median OS from start of 2 L (17.2 months) or 1 L (16.0 months) BRAF/MEKi was similar (p = 0.73) despite inherent bias from differing index dates. ORR among both groups (56.4 % vs 53.5 %; p = 0.32) was equal. Conclusion: This study further supports the recommended sequencing of ICI as 1 L and BRAF/MEKi as 2 L therapy for patients with BRAFV600-mutated melanoma. It shows that prior failure of ICI does not compromise the efficacy of BRAF/MEKi treatment.

Details

OriginalspracheEnglisch
Aufsatznummer100773
FachzeitschriftEJC Skin Cancer
Jahrgang4
PublikationsstatusVeröffentlicht - 2026
Peer-Review-StatusJa

Externe IDs

ORCID /0000-0003-4340-9706/work/210355487

Schlagworte

ASJC Scopus Sachgebiete

Schlagwörter

  • BRAF inhibitor, MEK inhibitor, Melanoma, Real-world-data, Second-line