Clinical characteristics, such as lactate dehydrogenase (LDH) concentration and organ sites with metastases, are associated with survival outcomes among patients with BRAFV600E-mutant or BRAFV600K-mutant advanced melanoma treated with dabrafenib plus trametinib, according to a study published in The Lancet Oncology.1

Researchers conducted a retrospective analysis of 617 patients with BRAFV600E-mutant or BRAFV600K-mutant metastatic melanoma who were treated with dabrafenib 150 mg twice daily along with trametinib 2 mg once daily.

Using univariate and multivariate analyses, the authors analyzed for factors during and after baseline based on known clinical and prognostic characteristics for melanoma to find any association with survival.

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In total, 290 of the observed patients had died, and 396 had progression events.  Survival rates were consistent among individual trials and were as follows: median progression-free survival (PFS) was 11.1 months, median overall survival was 25.6 months, 1-year PFS rate was 48%, 1-year overall survival rate was 74%, 2-year PFS rate was 30%, and 2-year overall survival rate was 53%.

Patients who had normal LDH concentration and fewer than 3 organ sites that contained metastases had a 1-year PFS rate of 68% and 1-year overall survival rate of 90%, as well as a 2-year PFS rate of 46% and a 2-year overall survival rate of 75%.

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In contrast, patients who had LDH concentrations that were “at least 2 times the upper limit of normal” had a 1-year PFS rate of 8% and a 1-year overall survival rate of 40%, as well as a 2-year PFS rate of 2% and a 2-year overall survival rate of 7%. 

Reference

  1. Long GV, Grob J, Nathan P, et al. Factors predictive of response, disease progression, and overall survival after dabrafenib and trametinib combination treatment: a pooled analysis of individual patient data from randomised trials. Lancet Oncol. 2016 Nov 15. doi: 10.1016/S1470-2045(16)30578-2 [Epub ahead of print]

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Melanoma Skin Cancer