Thursday, June 2, 2016

ASCO 2016 - Cobimetinib and Vermurafenib - coBRIM study

We have known from some time that BRAF/MEK combinations have better responses than either of those meds alone.  Just one notation is here:    "The COMBI-d trial (dabrafenib plus trametinib vs dabrafenib alone), the Combi-V trial (dabrafenib and trametinib vs vemurafenib alone) and the CoBRIM trial (vemurafenib with cobimetinib vs vemurafenib and placebo) all demonstrate the effectiveness of combination therapy when compared to one targeted therapy alone."  From this link:  Pick your poison - a discussion of treatment options by Weber and Agarwala
Now this from ASCO:

Efficacy of cobimetinib (C) and vemurafenib (V) in advanced BRAF-mutated melanoma patients (pts) with poor and favorable prognosis in the coBRIM phase III study.  ASCO 2016. # 9530.  J Clin Oncol 34, 2016.  McArthur, Larkin, Ascierto, et al.

Background: In coBRIM, C+V significantly improved PFS and OS versus placebo (P)+V in pts with BRAFV600-mutated advanced melanoma, with benefit in all prespecified subgroups evaluated. Prognostic factors in melanoma include LDH level, stage of disease, disease burden, number of organs involved, liver metastasis status, and ECOG status. Here we correlate efficacy outcomes with known prognostic factors in coBRIM pts. Methods:  Disease burden was sum of longest diameters (SLDs) of target lesions; presence of liver metastases was determined from case report forms. Results: Across all known melanoma poor prognostic factors, pts on C+V had greater PFS and OS benefit compared with P+V. PFS and OS were improved in C+V pts with all LDH levels, in pts with and without liver metastases at screening, those with disease burden greater than and less than or = to, the median disease burden in this population, those with greater than or = to, target organs, and among pts with the worst prognostic factors. Conclusions: C+V treatment results in PFS and OS improvement among BRAF-mutated melanoma with favorable and poor prognoses both. This benefit is apparent even among patients with a constellation of favorable and poor prognoses.

Thanks, ratties! - c

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