COMBI-EU: Real-World Evidence on Adverse Event Management and Time on Therapy with Adjuvant Dabrafenib Plus Trametinib in Patients with BRAF V600-Mutant Melanoma

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Michael Weichenthal - , University Hospital Schleswig-Holstein Campus Kiel (Author)
  • Dirk Debus - , Paracelsus Medical University Nuremberg (Author)
  • Lisa Zimmer - , University Hospital Essen (Author)
  • Imke von Wasielewski - , Hannover Medical School (MHH) (Author)
  • Friedegund Meier - , Department of Dermatology, National Center for Tumor Diseases Dresden (NCT/UCC), University Hospital Carl Gustav Carus Dresden (Author)
  • Thomas Tüting - , University Hospital Magdeburg (Author)
  • Markus V. Heppt - , Friedrich-Alexander University Erlangen-Nürnberg, University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg, Bavarian Center for Cancer Research (BZKF) (Author)
  • Jessica C. Hassel - , Heidelberg University  (Author)
  • Fabian Ziller - , DRK Hospital Chemnitz-Rabenstein (Author)
  • Peter Mohr - , Elbe Clinics Stade/Buxtehude (Author)
  • Pia Dücker - , Municipal Hospital Dortmund (Author)
  • Anca Sindrilaru - , Ulm University (Author)
  • Edgar Dippel - , Klinikum Ludwigshafen (Author)
  • Lucie Heinzerling - , Friedrich-Alexander University Erlangen-Nürnberg, Ludwig Maximilian University of Munich (Author)
  • Marc Bender - , Elbe Clinics Stade/Buxtehude (Author)
  • Manar Aoun - , Novartis AG (Author)
  • Magdalena Walecki - , EUMelaReg (Author)
  • Rudolf Herbst - , Fresenius AG (Author)
  • Yenny Angela - , Ruhr University Bochum (Author)
  • Rudolf Stadler - , Ruhr University Bochum (Author)
  • Sebastian Haferkampf - , University of Regensburg (Author)
  • Claus Detlev Klemke - , University Medical Center Freiburg (Author)
  • Kjell Matthias Kaune - , Bremen-Ost Hospital (Author)
  • Johannes Wohlrab - , Martin Luther University Halle-Wittenberg (Author)
  • Ulrike Leiter - , University Hospital Tübingen (Author)
  • Nessr Abu Rached - , Ruhr University Bochum (Author)
  • Jochen Utikal - , German Cancer Research Center (DKFZ), Heidelberg University  (Author)
  • Gaston Schley - , Fresenius AG (Author)
  • Jens Ulrich - , Otto von Guericke University Magdeburg (Author)
  • Erwin Schultz - , Paracelsus Medical University Nuremberg (Author)
  • Christoffer Gebhardt - , University of Hamburg (Author)
  • Patrick Terheyden - , University of Lübeck (Author)
  • Ralf Gutzmer - , Ruhr University Bochum (Author)
  • Dirk Schadendorf - , University Hospital Essen, German Cancer Research Center (DKFZ) (Author)

Abstract

Background/Objectives: Malignant melanoma is a highly aggressive cancer associated with significant mortality, underscoring the need for continued research efforts. COMBI-EU (NCT03944356) is a prospective, non-interventional study that aims to assess adjuvant dabrafenib and trametinib usage in clinical practice, the impact of AE management, and the usage of app-based documentation on treatment adherence. Methods: Adults with complete surgical resection of stage III BRAF V600-mutant cutaneous melanoma were included. The primary endpoint was median time on treatment (TOT). Adverse event (AE) management was classified as either a high or low level of management. The rating of AE management based on a self-developed algorithm and rules from COMBI-APlus was used to analyze the impact of AE management on TOT. App-based documentation of medication intake and patient-reported outcomes (CANKADO PRO-React; version 6.0, 06.03.2019) was offered. Results: For 225 patients, the median TOT was 11.8 months (95% confidence interval [CI]: 11.7, 12.0). Treatment was completed by 138 patients (61.3%); 37 (16.4%) discontinued due to treatment-related AEs (TRAEs). TRAEs (≥1) were experienced by 181 patients (80.4%); the most common was pyrexia (38.2%). High-level AE management showed a trend toward improved treatment adherence (high versus low level: hazard ratio [HR]: 0.74; 95% CI: 0.49, 1.14); this improvement was significant with pyrexia management (HR: 0.52; 95% CI: 0.29, 0.93). Seventy-nine (35%) and 33 patients (15%) intended to use and eventually used the app, respectively. A similar proportion of patients remained on treatment for 12 months irrespective of app usage (use, 39.4% vs. non-use, 36.5%). Conclusions: High-level TRAE management showed a trend toward improved treatment adherence, which was statistically significant for pyrexia. Optional use of an app did not influence treatment adherence.

Details

Original languageEnglish
Article number667
JournalCancers
Volume18
Issue number4
Publication statusPublished - Feb 2026
Peer-reviewedYes

External IDs

ORCID /0000-0003-4340-9706/work/210355486

Keywords

ASJC Scopus subject areas

Keywords

  • adjuvant, adverse event management, dabrafenib, melanoma, pyrexia, quality of life, trametinib