Binimetinib Improves PFS in NRAS-mutant Melanoma

Treatment with binimetinib prolonged progression-free survival compared with dacarbazine in NRAS-mutant melanoma.
Treatment with binimetinib prolonged progression-free survival compared with dacarbazine in NRAS-mutant melanoma.

Binimetinib significantly prolonged progression-free survival compared with dacarbazine and was associated with a manageable safety profile among patients with advanced, NRAS-mutant melanoma, according to a study published in The Lancet Oncology.1

For the ongoing, international, open-label, phase 3 NEMO trial (ClinicalTrials.gov Identifier: NCT01763164), researchers evaluated the efficacy and safety of binimetinib, a MEK inhibitor, compared with dacarbazine among patients with advanced NRAS-mutant melanoma.

Investigators enrolled 402 patients with advanced, unresectable, stage IIIC or IV NRAS mutation-positive melanoma who received no prior therapy or who progressed on or after immunotherapy. Participants were randomly assigned 2:1 to receive binimetinib 45 mg orally twice daily or intravenous dacarbazine 1000 mg/m2 every 3 weeks.

Median follow-up was 1.7 months. Treatment with binimetinib reduced the risk of progression or death by 38% compared with dacarbazine (hazard ratio [HR], 0.62; 95% CI, 0.47-0.80). Median progression-free survival was 2.8 months (95% CI, 2.8-3.6) with binimetinib vs 1.5 months (95% CI, 1.5-1.7) with dacarbazine.

Among patients who received previous immunotherapy, median progression-free survival was longer for those who received binimetinib than for those who received dacarbazine (5.5 months

[95% CI, 2.8-7.6] vs 1.6 months [95% CI, 1.5-2.8], respectively).

Fifteen percent (95% CI, 11-20) of binimetinib-treated patients achieved a confirmed overall response compared with 7% (95% CI, 3-13) of those who received dacarbazine (P = .015).

There was, however, no significant difference in overall survival between the 2 treatment arms.

RELATED: Acquired and Lost BRAF/MEK Resistance in Melanoma: A Prospective Study

About a third (34%) of binimetinib-treated patients experienced serious adverse events compared with 22% of those who received dacarbazine.

The findings suggest that binimetinib is a potential treatment strategy for patients with advanced NRAS-mutant melanoma, including those who fail previous immunotherapy.

Reference

  1. Dummer R, Schadendorf D, Ascierto PA, et al. Binimetinib versus dacarbazine in patients with advanced NRAS-mutant melanoma (NEMO): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2017 March 8. doi: 10.1016/S1470-2045(17)30180-8 [Epub ahead of print]

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs

Sign Up for Free e-newsletters