A phase 2 clinical trial of combined BRAF/MEK inhibition for BRAFV600E-mutated multiple myeloma

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Nicola Giesen - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Manik Chatterjee - , University Hospital of Würzburg (Author)
  • Christof Scheid - , Uniklinik Köln (Author)
  • Alexandra M Poos - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Britta Besemer - , University Hospital Tübingen (Author)
  • Kaya Miah - , German Cancer Research Center (DKFZ) (Author)
  • Axel Benner - , German Cancer Research Center (DKFZ) (Author)
  • Nicole Becker - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Thomas Moehler - , IQVIA Inc. (Author)
  • Ivana Metzler - , University Hospital Frankfurt (Author)
  • Cyrus Khandanpour - , University Hospital Münster (Author)
  • Andrea Seidel-Glaetzer - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Karolin Trautmann-Grill - , Department of internal Medicine I (Author)
  • K Martin Kortüm - , University Hospital of Würzburg (Author)
  • Carsten Müller-Tidow - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Gunhild Mechtersheimer - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Benjamin Goeppert - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Albrecht Stenzinger - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Niels Weinhold - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Hartmut Goldschmidt - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Katja Weisel - , University Hospital Hamburg Eppendorf (Author)
  • Marc S Raab - , National Center for Tumor Diseases (NCT) Heidelberg (Author)

Abstract

Activating BRAF mutations are found in a small subset of patients with newly diagnosed multiple myeloma, but prevalence increases in late-stage, refractory disease, and the mutations are associated with adverse outcome. This prospective single-arm, open-label, multicenter phase 2 trial assessed the efficacy and safety of combined BRAF/MEK inhibition, using encorafenib and binimetinib, in patients with relapsed/refractory multiple myeloma (RRMM) carrying a BRAFV600E mutation. Patients received 450 mg encorafenib once daily and binimetinib 45 mg twice daily. The primary end point was the overall response rate achieved within the first year after start of treatment according to International Myeloma Working Group criteria. Twelve RRMM patients with a median of 5 prior lines of therapy were enrolled. The overall response rate was 83.3%, with 10 patients achieving at least a partial response. The median progression-free survival was 5.6 months, and overall survival was 55% at 24 months. Emerging resistance to therapy was driven by RAS mutations and structural variants involving the BRAF locus. This is the first prospective clinical trial to demonstrate that combined BRAF/MEK inhibition is highly effective in patients with BRAFV600E-mutated RRMM, and it represents a successful targeted precision medicine approach in this disease. This trial was registered at www.clinicaltrials.gov as #NCT02834364.

Details

Original languageEnglish
Pages (from-to)1685-1690
Number of pages6
JournalBlood
Volume141
Issue number14
Publication statusPublished - 6 Apr 2023
Peer-reviewedYes

External IDs

Scopus 85149879908

Keywords

Keywords

  • Humans, Multiple Myeloma/drug therapy, Proto-Oncogene Proteins B-raf/genetics, Prospective Studies, Antineoplastic Combined Chemotherapy Protocols/adverse effects, Mitogen-Activated Protein Kinase Kinases/therapeutic use