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  • Long, Georgina V; Weber, Jeffrey S; Infante, Jeffrey R; Kim, Kevin B; Daud, Adil; Gonzalez, Rene; Sosman, Jeffrey A; Hamid, Omid; Schuchter, Lynn; Cebon, Jonathan; Kefford, Richard F; Lawrence, Donald; Kudchadkar, Ragini; Burris, 3rd, Howard A; Falchook, Gerald S; Algazi, Alain; Lewis, Karl; Puzanov, Igor; Ibrahim, Nageatte; Sun, Peng; Cunningham, Elizabeth; Kline, Amy S; Del Buono, Heather; McDowell, Diane Opatt; Patel, Kiran; Flaherty, Keith T

    Journal of clinical oncology, 2016-Mar-10, Letnik: 34, Številka: 8
    Journal Article

    To report the overall survival (OS) and clinical characteristics of BRAF inhibitor-naive long-term responders and survivors treated with dabrafenib plus trametinib in a phase I and II study of patients with BRAF V600 mutation-positive metastatic melanoma. BRAF inhibitor-naive patients treated with dabrafenib 150 mg twice daily plus trametinib 2 mg daily (the 150/2 group) from the non-randomly assigned (part B) and randomly assigned (part C) cohorts of the study were analyzed for progression-free and OS separately. Baseline characteristics and factors on treatment were analyzed for associations with durable responses and OS. For BRAF inhibitor-naive patients in the 150/2 groups (n = 78), the progression-free survival at 1, 2, and 3 years was 44%, 22%, and 18%, respectively, for part B (n = 24) and 41%, 25%, and 21%, respectively, for part C (n = 54). Median OS was 27.4 months in part B and 25 months in part C. OS at 1, 2, and 3 years was 72%, 60%, and 47%, respectively, for part B and 80%, 51%, and 38%, respectively, for part C. Prolonged survival was associated with metastases in fewer than three organ sites and lower baseline lactate dehydrogenase. OS at 3 years was 62% in patients with normal baseline lactate dehydrogenase and 63% in patients with a complete response. Dabrafenib plus trametinib results in a median OS of more than 2 years in BRAF inhibitor-naive patients with BRAF V600 mutation-positive metastatic melanoma, and approximately 20% were progression free at 3 years. Durable responses occurred in patients with good prognostic features at baseline, which may be predictive.