Primary Melanoma Treatment Outcome Factors Identified

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Sex, normal pretreatment serum lactate dehydrogenase (LDH) level, BRAF genotype, and primary melanoma ulceration status were identified as being independent factors associated with treatment outcomes in patients with melanoma, according to an article published online in the journal Cancer.

The study included 142 patients with BRAF-mutant metastatic melanoma who were categorized as consecutive immunotherapy- and mitogen-activated protein kinase (MAPK) inhibitor-naïve. During clinical trials, these patients were administered BRAF inhibitors (n=111) or received a combination of dabrafenib and trametinib (n=31).

Results showed the median follow-up was 15.7 months (range, 0.6 to 60.5 months) and the overall survival (OS) rates were 43% for 2-year, 24% for 3-year, and 24% for 4-year. The only clinicopathologic factors linked to longer progression-free survival (PFS) and OS were female sex and a normal serum LDH level pre-treatment.

An independent association was determined to exist between a longer PFS (but not OS) and the BRAF V600E genotype and an absence of primary melanoma ulceration.

Furthermore, patients with a normal LDH level had a median OS of 23.5 months while those with elevated LDH levels had a median OS of 7.3 months (HR, 0.31; P<0.001).

Patients who responded completely to treatment demonstrated the best survival; however, two of seven of these patients had relapses occur.

A minority of patients who were administered MAPK inhibitor treatment alone were observed to have a long-term survival.

Primary Melanoma Treatment Outcome Factors Identified
Sex, LDH level, BRAF genotype, and ulceration status identified as being independent factors associated with treatment outcomes in melanoma.
Menzies, A. M., Wilmott, J. S., Drummond, M., Lo, S., Lyle, M., Chan, M. M. K., Thompson, J. F., Guminski, A., Carlino, M. S., Scolyer, R. A., Kefford, R. F. and Long, G. V. (2015), Clinicopathologic features associated with efficacy and long-term survival in metastatic melanoma patients treated with BRAF or combined BRAF and MEK inhibitors.
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